Provider Demographics
NPI:1740477231
Name:LONDON, YEFIM (LAC)
Entity type:Individual
Prefix:
First Name:YEFIM
Middle Name:
Last Name:LONDON
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 1:1 RAPHAEL BLVD
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2700
Mailing Address - Country:US
Mailing Address - Phone:631-360-0211
Mailing Address - Fax:
Practice Address - Street 1:1 RAPHAEL BLVD
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2700
Practice Address - Country:US
Practice Address - Phone:631-360-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000267171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist