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General NPI Number Information
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NPI Number | 1891919171
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Entity Type | Individual
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Provider Name | LISA MARIE METZGER L.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 24 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301
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Country | US
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Telephone | 718-815-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 194 13TH ST
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City | BROOKLYN
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State | NY
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Zip | 11215-4703
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Country | US
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Telephone | 419-618-1928
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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 | 120
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25003955
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License Number State | NY
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