Provider Demographics
NPI:1215141650
Name:STORM, R. J. (MS, L AC)
Entity type:Individual
Prefix:
First Name:R. J.
Middle Name:
Last Name:STORM
Suffix:
Gender:M
Credentials:MS, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHAOYANG QU, XIBAHENANLI
Mailing Address - Street 2:16 BLDG., 1203 RM.
Mailing Address - City:BEIJING
Mailing Address - State:BEIJING
Mailing Address - Zip Code:100028
Mailing Address - Country:CN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 ROBIN LN
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2219
Practice Address - Country:US
Practice Address - Phone:845-313-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003417-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist