Provider Demographics
NPI:1346478559
Name:POWERS, JAMES GERARD (LAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GERARD
Last Name:POWERS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E 52ND ST
Mailing Address - Street 2:502
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5306
Mailing Address - Country:US
Mailing Address - Phone:212-371-9355
Mailing Address - Fax:646-695-4618
Practice Address - Street 1:16 E 52ND ST
Practice Address - Street 2:502
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5306
Practice Address - Country:US
Practice Address - Phone:212-371-9355
Practice Address - Fax:646-695-4618
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003654-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist