Provider Demographics
NPI:1508224932
Name:FLOATING LOTUS LLC
Entity Type:Organization
Organization Name:FLOATING LOTUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANIK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:212-600-0220
Mailing Address - Street 1:39 W 56TH ST
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3906
Mailing Address - Country:US
Mailing Address - Phone:212-600-0220
Mailing Address - Fax:
Practice Address - Street 1:39 W 56TH ST
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3906
Practice Address - Country:US
Practice Address - Phone:212-600-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-30
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005688171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty