Provider Demographics
NPI:1710471420
Name:PIECH, ELIZABETH ALEXANDRA (LAC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ALEXANDRA
Last Name:PIECH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ALEXANDRA
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3243 41ST ST # 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3502
Mailing Address - Country:US
Mailing Address - Phone:201-341-7548
Mailing Address - Fax:
Practice Address - Street 1:155 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-8001
Practice Address - Country:US
Practice Address - Phone:212-777-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist