Provider Demographics
NPI:1154890630
Name:IVES ACUPUNCTURE PLLC
Entity type:Organization
Organization Name:IVES ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:IVES
Authorized Official - Last Name:GARSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-694-1940
Mailing Address - Street 1:99 MOORE ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-3371
Mailing Address - Country:US
Mailing Address - Phone:646-694-1940
Mailing Address - Fax:
Practice Address - Street 1:80 8TH AVE STE 1304
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7161
Practice Address - Country:US
Practice Address - Phone:646-694-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty