MEDICARE: JENNIFER ROSE URETSKY LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	007946	NY

General Provider Information

NPI Number	:	1144156001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROSE URETSKY LAC

Provider Business Mailing Address
First Line	:	232 BILTMORE BLVD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MONTAUK HWY
Second Line	:
City	:	WEST SAYVILLE
State	:	NY
Zip	:	11796-1801
Country	:	US
Telephone Number	:	631-210-6193
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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