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General NPI Number Information
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NPI Number | 1194133926
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Entity Type | Individual
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Provider Name | LYUDMILA AVSHALUMOVA L.AC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 104-08 ROOSEVELT AVE
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City | CORONA
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State | NY
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Zip | 11368
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Country | US
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Telephone | 718-429-0545
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Fax | 718-499-1200
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Provider Business Mailing Address
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Address Line | 441 OCEAN PKWY APT. 4E
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City | BROOKLYN
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State | NY
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Zip | 11218-5154
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Country | US
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Telephone | 646-509-8983
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Fax | 718-941-4009
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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 | 002911
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License Number State | NY
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