Healthcare Provider Details

I. General information

NPI: 1790645034
Provider Name (Legal Business Name): INNER HEALTH ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HORSEBLOCK RD
FARMINGVILLE NY
11738-1240
US

IV. Provider business mailing address

700 HORSEBLOCK RD
FARMINGVILLE NY
11738-1240
US

V. Phone/Fax

Practice location:
  • Phone: 631-478-7952
  • Fax: 631-732-1544
Mailing address:
  • Phone: 631-478-7952
  • Fax: 631-732-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALICIA ANDRIA
Title or Position: PRESIDENT
Credential: L.AC., MT
Phone: 631-478-7952