MEDICARE: ERIKA PEMBERTON L.AC.

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	003111	NY

General Provider Information

NPI Number	:	1962611715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA PEMBERTON L.AC.

Provider Business Mailing Address
First Line	:	32 UNION SQ E
Second Line	:	SUITE 615 N
City	:	NEW YORK
State	:	NY
Zip	:	10003-3209
Country	:	US
Telephone Number	:	917-586-5448
Fax Number	:	212-674-2399

Provider Business Practice Location Address
First Line	:	32 UNION SQ E
Second Line	:	SUITE 615 N
City	:	NEW YORK
State	:	NY
Zip	:	10003-3209
Country	:	US
Telephone Number	:	917-586-5448
Fax Number	:	212-674-2399

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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Directions to “ ERIKA PEMBERTON L.AC.” Practice Location

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