Provider Demographics
NPI:1275363319
Name:BREAKTHRU ACUPUNCTURE PC
Entity type:Organization
Organization Name:BREAKTHRU ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEV
Authorized Official - Middle Name:
Authorized Official - Last Name:VYSHEDSKY
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:917-439-8577
Mailing Address - Street 1:99 HILLSIDE AVE APT 16I
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2722
Mailing Address - Country:US
Mailing Address - Phone:917-439-8577
Mailing Address - Fax:
Practice Address - Street 1:14-25 PLAZA RD STE S22
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3591
Practice Address - Country:US
Practice Address - Phone:917-439-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty