Provider Demographics
NPI:1609284967
Name:BL HEALTHY LIFE ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:BL HEALTHY LIFE ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBCHYNSKA
Authorized Official - Suffix:
Authorized Official - Credentials:ORIENTAL MEDDOCTOR
Authorized Official - Phone:917-561-2168
Mailing Address - Street 1:134 BEACH 98TH STREET
Mailing Address - Street 2:ROCKAWAY PARK
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2851
Mailing Address - Country:US
Mailing Address - Phone:718-945-6076
Mailing Address - Fax:718-945-6076
Practice Address - Street 1:134 BEACH 98TH STREET, SUITE 1
Practice Address - Street 2:ROCKAWAY PARK
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11694-2851
Practice Address - Country:US
Practice Address - Phone:718-945-6076
Practice Address - Fax:718-945-6076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BL HEALTHY LIFE ACUPUNCTURE P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002381171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty