Provider Demographics
NPI:1053617399
Name:GOLDEN LOTUS ACUPUNCTURE P.C.
Entity type:Organization
Organization Name:GOLDEN LOTUS ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSHITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:732-740-7709
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-0008
Mailing Address - Country:US
Mailing Address - Phone:732-740-7709
Mailing Address - Fax:732-677-3636
Practice Address - Street 1:27 KINGFISHER CT
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2504
Practice Address - Country:US
Practice Address - Phone:732-740-7709
Practice Address - Fax:732-677-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00079700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty