Provider Demographics
NPI:1841594405
Name:YAMAGUCHI, YOSHIHIRO (LAC)
Entity Type:Individual
Prefix:DR
First Name:YOSHIHIRO
Middle Name:
Last Name:YAMAGUCHI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W 54TH ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5322
Mailing Address - Country:US
Mailing Address - Phone:212-246-7588
Mailing Address - Fax:212-767-0770
Practice Address - Street 1:161 W 54TH ST
Practice Address - Street 2:SUITE 21
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5322
Practice Address - Country:US
Practice Address - Phone:212-246-7588
Practice Address - Fax:212-767-0770
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000359171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000359OtherNYS LIC