Provider Demographics
NPI:1558667162
Name:MICHIE HOSHINO L AC PC
Entity Type:Organization
Organization Name:MICHIE HOSHINO L AC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSHINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-291-8609
Mailing Address - Street 1:8204 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1413
Mailing Address - Country:US
Mailing Address - Phone:917-291-8609
Mailing Address - Fax:
Practice Address - Street 1:8204 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1413
Practice Address - Country:US
Practice Address - Phone:917-291-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000813261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy