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General NPI Number Information
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NPI Number | 1073997730
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Entity Type | Individual
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Provider Name | YURI LANTSMAN
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Gender | Male
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 205-20 JAMAICA AVE
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City | HOLLIS
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State | NY
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Zip | 11423
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Country | US
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Telephone | 917-362-6452
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 443
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City | FORT LEE
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State | NJ
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Zip | 07024
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Country | US
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Telephone | 917-362-6452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 002954
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License Number State | NY
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