Provider Demographics
NPI:1992489686
Name:LAKESIDE ACUPUNCTURE AND MASSAGE PC
Entity type:Organization
Organization Name:LAKESIDE ACUPUNCTURE AND MASSAGE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JING
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-963-5525
Mailing Address - Street 1:13604 CHERRY AVE APT LA
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4840
Mailing Address - Country:US
Mailing Address - Phone:917-963-5525
Mailing Address - Fax:
Practice Address - Street 1:22038 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3643
Practice Address - Country:US
Practice Address - Phone:718-819-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty