Justin Wilfred Dougherty, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25005672 Issued in NY

Practice address

516 Lakeville Rd
New Hyde Park, NY 11040-3006

Phone

(516) 993-1416

NPI assigned

Nov 11, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bliss Acupuncture P.C.

  • Acupuncturist
  • New Hyde Park, NY
  • NPI 1366890535
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1407229594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110400769",
            "telephone_number": "516-993-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403006",
            "telephone_number": "516-993-1416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JUSTIN",
        "middle_name": "WILFRED",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-11",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "25005672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Dorfman, PSYD
• William Doscher, MD
• Pankti Priyen Doshi
• Nathalie Douge, M.D.
• Joel William Dougherty
• Soffiear Douglin
• Caitlin Dowling, MD
• Olivia Downey, PA-C
• Downstate Clinical Laboratories Inc
• Sule Doymaz

• Acupuncturist in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.