Healthcare Provider Details

I. General information

NPI: 1346849262
Provider Name (Legal Business Name): REDDY FOR ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 MERRICK RD
BELLMORE NY
11710-5724
US

IV. Provider business mailing address

11 MARJORIE LN
EAST ROCKAWAY NY
11518-2020
US

V. Phone/Fax

Practice location:
  • Phone: 516-205-1377
  • Fax:
Mailing address:
  • Phone: 516-713-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA REDDY
Title or Position: PRESIDENT
Credential: L.AC
Phone: 516-713-7833