Provider Demographics
NPI:1831559574
Name:LINGAT, MARC ANTHONY (L AC)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:ANTHONY
Last Name:LINGAT
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 36TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:373 BROADWAY
Practice Address - Street 2:SUITE 506
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3926
Practice Address - Country:US
Practice Address - Phone:917-681-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 005548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist