MEDICARE: PETER D'AQUINO L.AC.

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	004680-1	NY

General Provider Information

NPI Number	:	1750665675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER D'AQUINO L.AC.

Provider Business Mailing Address
First Line	:	138 SKILLMAN AVE APT 3R
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-2439
Country	:	US
Telephone Number	:	917-582-7044
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 SKILLMAN AVE APT 3R
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-2439
Country	:	US
Telephone Number	:	917-582-7044
Fax Number	:

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

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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Directions to “ PETER D'AQUINO L.AC.” Practice Location

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