Provider Demographics
NPI:1346988748
Name:MCCALL, FLORENCE GRACE (LAC)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:GRACE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 WILLOUGHBY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-6383
Mailing Address - Country:US
Mailing Address - Phone:646-884-1141
Mailing Address - Fax:
Practice Address - Street 1:1006 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-1888
Practice Address - Country:US
Practice Address - Phone:646-884-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist