Provider Demographics
NPI:1679785430
Name:LIFEWAY ACUPUNCTURE, P.C.
Entity type:Organization
Organization Name:LIFEWAY ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRZEJ
Authorized Official - Middle Name:
Authorized Official - Last Name:DARLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-835-4199
Mailing Address - Street 1:PO BOX 754098
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-9098
Mailing Address - Country:US
Mailing Address - Phone:718-835-4199
Mailing Address - Fax:718-835-2989
Practice Address - Street 1:8838 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2138
Practice Address - Country:US
Practice Address - Phone:718-835-4199
Practice Address - Fax:718-835-2989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001906171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty