Provider Demographics
NPI:1528758604
Name:TOWSE, ANGUS JUSTIN (LAC, LMT)
Entity type:Individual
Prefix:
First Name:ANGUS
Middle Name:JUSTIN
Last Name:TOWSE
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HENDRICK AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2907
Mailing Address - Country:US
Mailing Address - Phone:516-640-2127
Mailing Address - Fax:
Practice Address - Street 1:39 HENDRICK AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2907
Practice Address - Country:US
Practice Address - Phone:516-640-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005397171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist