Provider Demographics
NPI:1376983221
Name:ISLAND COMMUNITY ACUPUNCTURE, P.C.
Entity Type:Organization
Organization Name:ISLAND COMMUNITY ACUPUNCTURE, P.C.
Other - Org Name:LC ACUPUNCTURE FOR PAIN RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:516-946-0851
Mailing Address - Street 1:717 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4534
Mailing Address - Country:US
Mailing Address - Phone:516-946-0851
Mailing Address - Fax:516-570-3536
Practice Address - Street 1:717 FRONT STREET
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3648
Practice Address - Country:US
Practice Address - Phone:516-376-3703
Practice Address - Fax:516-570-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty