Provider Demographics
NPI:1235737677
Name:TRINITY VILLAGE ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:TRINITY VILLAGE ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JADE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LOMINY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-358-7503
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-0176
Mailing Address - Country:US
Mailing Address - Phone:347-358-7503
Mailing Address - Fax:
Practice Address - Street 1:3 MEADOWRUE LN
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-2607
Practice Address - Country:US
Practice Address - Phone:347-358-7503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty