Provider Demographics
NPI:1528546785
Name:YOSHIFUJI, MICHIKO (LAC)
Entity Type:Individual
Prefix:MS
First Name:MICHIKO
Middle Name:
Last Name:YOSHIFUJI
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 1:20560 BRIAN CRES FL 3
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1142
Mailing Address - Country:US
Mailing Address - Phone:631-379-2583
Mailing Address - Fax:
Practice Address - Street 1:20560 BRIAN CRES FL 3
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1142
Practice Address - Country:US
Practice Address - Phone:631-379-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty