Healthcare Provider Details

I. General information

NPI: 1548320930
Provider Name (Legal Business Name): ANNE MOK LAC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 COURT ST
BROOKLYN NY
11231-4032
US

IV. Provider business mailing address

476 COURT ST
BROOKLYN NY
11231-4032
US

V. Phone/Fax

Practice location:
  • Phone: 718-254-4075
  • Fax: 718-254-7004
Mailing address:
  • Phone: 718-254-4075
  • Fax: 718-254-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number001662-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: