Provider Demographics
NPI:1841052701
Name:LIM, ESTHER C (LAC)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:C
Last Name:LIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15029 25TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3644
Mailing Address - Country:US
Mailing Address - Phone:646-571-9533
Mailing Address - Fax:
Practice Address - Street 1:15029 25TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3644
Practice Address - Country:US
Practice Address - Phone:646-571-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007468171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist