Alexandra Lore, L. AC.
Individual provider Active NPI Acupuncturist · Speonk, NY
NPI 1366486573 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366486573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 002672-01 (NY)
- Practice address
- 295 Montauk Hwy
Speonk, NY 11934 - Phone
- (631) 255-0611
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002672-01 | NY | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 002672-01 | NY | Yes |
Addresses
Primary practice location
295 Montauk Hwy
Speonk, NY 11934
Mailing address
PO Box 167
Speonk, NY 11972
Phone (631) 255-0611
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002672-1 | Other | NY | ACUPUNCTURIST |
Other providers in Speonk, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.