Organization
SUP ACUPUNCTURE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIPING JIN LAC (OWNER)
(516) 474-9668
Entity
Organization
Contact information
Practice address
1075 ROUTE 112, PORT JEFFERSON STATION, NY 11776-8051
(516) 474-9668
Mailing address
664 MAY ST, SOUTH HEMPSTEAD, NY 11550-7925
(516) 474-9668
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005527
NY
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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