Healthcare Provider Details

I. General information

NPI: 1598260150
Provider Name (Legal Business Name): LAURA SNIPER LAC, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 AVENUE U
BROOKLYN NY
11229-4917
US

IV. Provider business mailing address

2316 AVENUE U
BROOKLYN NY
11229-4917
US

V. Phone/Fax

Practice location:
  • Phone: 917-843-3352
  • Fax:
Mailing address:
  • Phone: 917-843-3352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number028096
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006168
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: