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General NPI Number Information
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NPI Number | 1912346545
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Entity Type | Individual
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Provider Name | LAURENCE PATRICK MAGUIRE IV L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 464 MANOR RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-2956
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Country | US
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Telephone | 718-442-6690
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Fax |
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Provider Business Mailing Address
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Address Line | 50 BROADWAY APT #2
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City | AMITYVILLE
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State | NY
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Zip | 11701-2774
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Country | US
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Telephone | 917-697-1712
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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 | 001616
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License Number State | NY
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