Provider Demographics
NPI:1407326739
Name:HSU, ERICA REI (LAC, DACM)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:REI
Last Name:HSU
Suffix:
Gender:F
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:REI
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7 LOMA PL STE 3
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2805
Mailing Address - Country:US
Mailing Address - Phone:631-629-5355
Mailing Address - Fax:
Practice Address - Street 1:7 LOMA PL STE 3
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2805
Practice Address - Country:US
Practice Address - Phone:631-629-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-29
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005767171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist