Provider Demographics
NPI:1912170242
Name:ROBERTS, JOY ANNE (LAC)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:ANNE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:ANNE
Other - Last Name:LINDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:401 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231
Mailing Address - Country:US
Mailing Address - Phone:718-246-1806
Mailing Address - Fax:
Practice Address - Street 1:401 COURT STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231
Practice Address - Country:US
Practice Address - Phone:718-246-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist