Provider Demographics
NPI:1326116245
Name:FUCHS, MIRIAM YVETTE (MTOM, LAC)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:YVETTE
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MTOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17234 133RD AVE
Mailing Address - Street 2:APT. 5B SECTION C
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3957
Mailing Address - Country:US
Mailing Address - Phone:718-527-7362
Mailing Address - Fax:
Practice Address - Street 1:17234 133RD AVE
Practice Address - Street 2:APT. 5B SECTION C
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3957
Practice Address - Country:US
Practice Address - Phone:718-527-7362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002378171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist