Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Ryder J. Champouillon, MSOM, LAC

Individual provider Acupuncturist · NPI 1265763072

Mr. Ryder J. Champouillon, MSOM, LAC is an Acupuncturist in Port Jefferson Station, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010
What do these letters mean?
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

See every abbreviation used in this directory →

Practice location Address checks out

166 Bergen St
Port Jefferson Station, NY 11776-1910
Phone: (631) 629-5433
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence 003573-1 (NY)

Record details

NPI number1265763072
Entity typeIndividual (Type 1)
GenderMale
Credentials MSOM , LAC
Sole proprietorNo
NPI enumeratedJanuary 18, 2010
Last updated in NPPESAugust 9, 2013

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