Provider Demographics
NPI:1548522097
Name:BEHR, WILLIAM T JR (LIC AC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:T
Last Name:BEHR
Suffix:JR
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 ROUTE 25A
Mailing Address - Street 2:SUITE G
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9552
Mailing Address - Country:US
Mailing Address - Phone:631-513-3767
Mailing Address - Fax:
Practice Address - Street 1:745 ROUTE 25A
Practice Address - Street 2:SUITE G
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9552
Practice Address - Country:US
Practice Address - Phone:631-513-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000471171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist