Active NPI
Connie Lynn Ma, LAC, MSTOM
- Acupuncturist
- New York, NY
National Provider Identifier
1457622607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 004749-1
- Practice address
- 1 Park Ave
New York, NY 10016-5802 - Phone
- (917) 517-8220
- NPI assigned
- Jan 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 004749-1 | NY | Primary |
Addresses
Primary practice location
1 Park Ave
New York, NY 10016-5802
Mailing address
111 Hicks St
Apt 17M
Brooklyn, NY 11201-1658
Phone (917) 517-8220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004749-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1457622607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HICKS ST",
"address_2": "APT 17M",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011658",
"telephone_number": "917-517-8220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165802",
"telephone_number": "917-517-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MA",
"first_name": "CONNIE",
"middle_name": "LYNN",
"credential": "LAC, MSTOM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "004749-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.