Provider Demographics
NPI:1912406513
Name:HIRANO, YUUKI (LAC)
Entity Type:Individual
Prefix:
First Name:YUUKI
Middle Name:
Last Name:HIRANO
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 1:212 RICHBELL RD APT C4
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3227
Mailing Address - Country:US
Mailing Address - Phone:914-261-7936
Mailing Address - Fax:
Practice Address - Street 1:421 HUGUENOT ST STE 31
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7021
Practice Address - Country:US
Practice Address - Phone:914-365-1064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006052171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist