Provider Demographics
NPI:1235347592
Name:RICE, ELIZABETH CHANDLER (LAC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHANDLER
Last Name:RICE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 W 215TH ST APT 6C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1206
Mailing Address - Country:US
Mailing Address - Phone:212-304-8643
Mailing Address - Fax:
Practice Address - Street 1:165 W 91ST ST APT 8E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1357
Practice Address - Country:US
Practice Address - Phone:917-846-3259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001218171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist