Provider Demographics
NPI:1386716629
Name:YONKE, RICHARD JAMES (LAC, LMT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:YONKE
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:486 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1953
Mailing Address - Country:US
Mailing Address - Phone:718-845-5252
Mailing Address - Fax:718-845-6464
Practice Address - Street 1:15705 CROSSBAY BLVD
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2748
Practice Address - Country:US
Practice Address - Phone:718-845-5252
Practice Address - Fax:718-845-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist