Provider Demographics
NPI:1982118493
Name:VON MILLER, LYNDSAY (DACM)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:VON MILLER
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ECKFORD ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-3237
Mailing Address - Country:US
Mailing Address - Phone:917-826-4538
Mailing Address - Fax:
Practice Address - Street 1:68 3RD ST STE 246
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4808
Practice Address - Country:US
Practice Address - Phone:917-826-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005828171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist