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NPI Code Detail

MEDICARE: MISS LAUREN DELLER M.S., LAC

MEDICARE: MISS LAUREN DELLER M.S., 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
1171100000XAcupuncturist3982NY

General Provider Information

NPI Number : 1831336361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LAUREN DELLER M.S., LAC
Provider Business Mailing Address
First Line : 2460 VICTORY BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6612
Country : US
Telephone Number : 646-369-9583
Fax Number : 718-981-3574
Provider Business Practice Location Address
First Line : 2460 VICTORY BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6612
Country : US
Telephone Number : 646-369-9583
Fax Number : 718-981-3574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2009
Last Update Date : 06/24/2021

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