Healthcare Provider Details

I. General information

NPI: 1285551093
Provider Name (Legal Business Name): LINCOLN AVENUE ACUPUNCTURE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 COLDEN ST STE 102
FLUSHING NY
11355-3981
US

IV. Provider business mailing address

4231 COLDEN ST STE 102
FLUSHING NY
11355-3981
US

V. Phone/Fax

Practice location:
  • Phone: 516-666-7789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JANET SMITH
Title or Position: MANAGER
Credential:
Phone: 516-666-7789