Provider Demographics
NPI:1710292453
Name:THUROFF, DAVID C (LAC LMT DIPLOM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:THUROFF
Suffix:
Gender:M
Credentials:LAC LMT DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 BELL BLVD
Mailing Address - Street 2:LG
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2045
Mailing Address - Country:US
Mailing Address - Phone:646-221-8487
Mailing Address - Fax:
Practice Address - Street 1:51 W 14TH ST
Practice Address - Street 2:SUITE 3F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-0110
Practice Address - Country:US
Practice Address - Phone:646-221-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist