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General NPI Number Information
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NPI Number | 1851809024
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Entity Type | Individual
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Provider Name | HUONG TUYET HUYNH LAC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 253 MAIN ST
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City | NORTHPORT
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State | NY
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Zip | 11768-1730
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Country | US
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Telephone | 631-292-9950
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Fax | 631-651-5030
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Provider Business Mailing Address
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Address Line | 416 EASTON ST
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City | RONKONKOMA
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State | NY
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Zip | 11779-6104
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Country | US
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Telephone | 631-879-7248
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Fax | 631-991-7547
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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 | 006171
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License Number State | NY
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