Provider Demographics
NPI:1174632020
Name:TOUILI, MAURICE (LAC)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:TOUILI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 9TH AVENUE
Mailing Address - Street 2:APT 5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-414-0918
Mailing Address - Fax:
Practice Address - Street 1:451 CLARKSON AVENUE
Practice Address - Street 2:G BLDG ADMINISTRATION DEPT PSYCHIATRY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001508171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist