MEDICARE: JUDD ENGELBRECHT LAC

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	007361	NY

General Provider Information

NPI Number	:	1851135669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDD ENGELBRECHT LAC

Provider Business Mailing Address
First Line	:	529 W 42ND ST APT 4V
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-6228
Country	:	US
Telephone Number	:	917-531-8963
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 E 22ND ST STE P2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-6315
Country	:	US
Telephone Number	:	917-531-8963
Fax Number	:

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

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/25/2024

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