Provider Demographics
NPI:1942780036
Name:ACUPUNCTURE IS MY LIFE, PLLC.
Entity Type:Organization
Organization Name:ACUPUNCTURE IS MY LIFE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:888-607-3360
Mailing Address - Street 1:24711 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1846
Mailing Address - Country:US
Mailing Address - Phone:888-607-3360
Mailing Address - Fax:888-651-0877
Practice Address - Street 1:24711 UNION TPKE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1846
Practice Address - Country:US
Practice Address - Phone:888-607-3360
Practice Address - Fax:888-651-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005011171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty