Provider Demographics
NPI:1629398805
Name:VARGAS, EULIX (LAC)
Entity Type:Individual
Prefix:
First Name:EULIX
Middle Name:
Last Name:VARGAS
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 1:292 DELANCEY ST APT 13E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3629
Mailing Address - Country:US
Mailing Address - Phone:917-605-6742
Mailing Address - Fax:
Practice Address - Street 1:850 7TH AVE STE 904
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5438
Practice Address - Country:US
Practice Address - Phone:917-605-6742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004207171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist