Provider Demographics
NPI:1760517908
Name:LUDDEN, ANTOINETTE (ACUPUNCTURE)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:
Last Name:LUDDEN
Suffix:
Gender:F
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2222
Mailing Address - Country:US
Mailing Address - Phone:516-922-8222
Mailing Address - Fax:516-922-6484
Practice Address - Street 1:212 SOUTH ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2222
Practice Address - Country:US
Practice Address - Phone:516-922-8222
Practice Address - Fax:516-922-6484
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001762171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist