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General NPI Number Information
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NPI Number | 1235737677
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Entity Type | Organization
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Legal Business Name | TRINITY VILLAGE ACUPUNCTURE, PLLC
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 3 MEADOWRUE LN
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City | CORAM
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State | NY
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Zip | 11727-2607
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Country | US
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Telephone | 347-358-7503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | CORAM
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State | NY
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Zip | 11727-0176
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Country | US
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Telephone | 347-358-7503
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JADE ELIZABETH LOMINY
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Credential | LAC
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Telephone | 347-358-7503
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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 |
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License Number State |
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