Healthcare Provider Details

I. General information

NPI: 1275806325
Provider Name (Legal Business Name): ENERGY WORKS CENTER OF AUBURN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOFFMAN ST
AUBURN NY
13021-2157
US

IV. Provider business mailing address

1 HOFFMAN ST
AUBURN NY
13021-2157
US

V. Phone/Fax

Practice location:
  • Phone: 315-704-0319
  • Fax: 315-704-0160
Mailing address:
  • Phone: 315-704-0319
  • Fax: 315-704-0160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1816361
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0046141
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0228901
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0250191
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0252681
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0169851
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0224841
License Number StateNY

VIII. Authorized Official

Name: MRS. MARY ANNE GIACONA
Title or Position: CEO
Credential: TH.M.
Phone: 315-704-0319