Healthcare Provider Details

I. General information

NPI: 1346187267
Provider Name (Legal Business Name): CHRISTOPHER BOEHM LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 5TH AVE RM 1209
NEW YORK NY
10016-6648
US

IV. Provider business mailing address

522 W 148TH ST APT C
NEW YORK NY
10031-4112
US

V. Phone/Fax

Practice location:
  • Phone: 347-789-2785
  • Fax:
Mailing address:
  • Phone: 347-789-2785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007907
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: