# LODES ACUPUNCTURE AND PHYSICAL THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740639806
- **Authorized official:** JESSIE JIMENEZ (OFFICE MANAGER)
- **Authorized official phone:** (347) 665-8446

## Contact information

- **Practice address:** 6937 MYRTLE AVE, GLENDALE, NY 11385-7265
- **Practice address phone:** (347) 665-8446
- **Practice address fax:** (718) 381-0700
- **Mailing address:** 6937 MYRTLE AVE, GLENDALE, NY 11385-7265
- **Mailing address phone:** (347) 665-8446
- **Mailing address fax:** (718) 381-0700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 0045351 | NY | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | 0271821 | NY | — |

## Other

- **Enumeration date:** 06/09/2016
- **Last updated:** 06/09/2016