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General NPI Number Information
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NPI Number | 1437398401
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Entity Type | Individual
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Provider Name | MONA LEE L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 2954 CLARK AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-1944
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Country | US
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Telephone | 516-766-0897
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Fax | 516-766-0318
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Provider Business Mailing Address
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Address Line | 2954 CLARK AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-1944
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Country | US
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Telephone | 516-766-0897
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Fax | 516-766-0318
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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 | 003490-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008317-1
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License Number State | NY
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