Provider Demographics
NPI:1508221748
Name:LARKIN, MAUREEN (LAC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:LARKIN
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 1:291 BROADWAY RM 806
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1912
Mailing Address - Country:US
Mailing Address - Phone:646-269-2615
Mailing Address - Fax:
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 638
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:646-269-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002285171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist