MR. RYDER J. CHAMPOUILLON MSOM L.AC NPI 1265763072

NPI Information

NPI: 1265763072
Provider Name: MR. RYDER J. CHAMPOUILLON, MSOM, L.AC
Classification: Acupuncturist - 171100000X
Entity Type: Individual
Address:
166 BERGEN ST
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 629-5433
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MR. Ryder J. Champouillon, MSOM, L.AC is an acupuncturist in Port Jefferson Station, NY. The provider is an acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. MR. Ryder J. Champouillon, MSOM, L.AC NPI is 1265763072. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

166 BERGEN ST
PORT JEFFERSON STATION, NY
ZIP 11776-910
Phone: (631) 629-5433

The enumeration date for this NPI number is 1/18/2010 and was last updated on 8/9/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171100000X	Acupuncturist		003573-1	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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