Healthcare Provider Details

I. General information

NPI: 1992917306
Provider Name (Legal Business Name): LYNN ARENA L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNETTE ARENA L. AC.

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 HEWLETT POINT AVE
EAST ROCKAWAY NY
11518-2426
US

IV. Provider business mailing address

88 HEWLETT POINT AVE
EAST ROCKAWAY NY
11518-2426
US

V. Phone/Fax

Practice location:
  • Phone: 516-792-5791
  • Fax:
Mailing address:
  • Phone: 516-792-5791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25 003119
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: