Provider Demographics
NPI:1417693763
Name:LISA SUMPTION ACUPUNCTURE
Entity Type:Organization
Organization Name:LISA SUMPTION ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ACUPUNCTURE, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUMPTION
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:917-886-5860
Mailing Address - Street 1:598 BROADWAY FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3351
Mailing Address - Country:US
Mailing Address - Phone:917-886-5860
Mailing Address - Fax:
Practice Address - Street 1:598 BROADWAY FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3351
Practice Address - Country:US
Practice Address - Phone:917-886-5860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty