Provider Demographics
NPI:1326619248
Name:BARUA, NEENA (LAC)
Entity Type:Individual
Prefix:
First Name:NEENA
Middle Name:
Last Name:BARUA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:161 W 61ST ST APT 30FG
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7400
Mailing Address - Country:US
Mailing Address - Phone:551-427-2545
Mailing Address - Fax:
Practice Address - Street 1:20 E 49TH ST # 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1023
Practice Address - Country:US
Practice Address - Phone:551-427-2545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006878-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist