Spirit Gate Acupuncture PC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

000240 Issued in NY

Legal business name

SPIRIT GATE ACUPUNCTURE PC

Practice address

85 Walnut St
Lynbrook, NY 11563-2139

Phone

(516) 823-2511

NPI assigned

Aug 19, 2015

Organization subpart

No

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

Authorized official

Name

Suzanne Clegg, R.D., L.AC.NPI 1508232950

Title

President

Phone

(516) 823-2511

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzanne Clegg

  • Acupuncturist
  • Lynbrook, NY
  • NPI 1508232950

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1598131963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 WALNUT ST",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WALNUT ST",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632139",
            "telephone_number": "516-823-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT GATE ACUPUNCTURE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-823-2511",
        "authorized_official_credential": "R.D., L.AC."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "000240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Lynbrook, NY
• Providers in Lynbrook, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.