Healthcare Provider Details

I. General information

NPI: 1972240539
Provider Name (Legal Business Name): ALTERNATIVE APPROACH ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E MAIN ST
EAST PATCHOGUE NY
11772-3105
US

IV. Provider business mailing address

235 E MAIN ST
EAST PATCHOGUE NY
11772-3105
US

V. Phone/Fax

Practice location:
  • Phone: 631-539-6285
  • Fax: 631-731-4049
Mailing address:
  • Phone: 631-539-6285
  • 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: KELLY ANN PARISH
Title or Position: OWNER
Credential:
Phone: 631-619-0369