MEDICARE: MR. LLOYD JAMES MSTOM, LAC, C.SMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	002395	NY

General Provider Information

NPI Number	:	1134393077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LLOYD JAMES MSTOM, LAC, C.SMA

Provider Business Mailing Address
First Line	:	49 E 58TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3713
Country	:	US
Telephone Number	:	347-668-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 EXCHANGE PL
Second Line	:	TRS INC PROFESSIONAL SUITE 3RD FL
City	:	NEW YORK
State	:	NY
Zip	:	10005-2701
Country	:	US
Telephone Number	:	347-668-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	08/19/2015

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