Provider Demographics
NPI:1255468070
Name:MUKAI, GREG (L AC, MS)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:MUKAI
Suffix:
Gender:M
Credentials:L AC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ELM ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-1209
Mailing Address - Country:US
Mailing Address - Phone:607-746-8880
Mailing Address - Fax:
Practice Address - Street 1:20 ELM ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-1209
Practice Address - Country:US
Practice Address - Phone:607-746-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY872171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist