Provider Demographics
NPI:1447616289
Name:OCEANS & RIVERS LLC
Entity Type:Organization
Organization Name:OCEANS & RIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUNTLEROY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-913-0037
Mailing Address - Street 1:1841 BROADWAY RM 505
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7689
Mailing Address - Country:US
Mailing Address - Phone:718-913-0037
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY RM 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7689
Practice Address - Country:US
Practice Address - Phone:718-913-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-09
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty