Provider Demographics
NPI:1851651707
Name:SUZUKI, YASUSHI (LAC)
Entity Type:Individual
Prefix:MR
First Name:YASUSHI
Middle Name:
Last Name:SUZUKI
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 1:241 W 37TH ST RM 405
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6888
Mailing Address - Country:US
Mailing Address - Phone:212-470-3258
Mailing Address - Fax:
Practice Address - Street 1:241 W 37TH ST RM 405
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6888
Practice Address - Country:US
Practice Address - Phone:212-470-3258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004459171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist