Healthcare Provider Details

I. General information

NPI: 1679293591
Provider Name (Legal Business Name): METAL MONKEY ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 LINCOLN PL
GLEN COVE NY
11542-1949
US

IV. Provider business mailing address

22 LINCOLN PL
GLEN COVE NY
11542-1949
US

V. Phone/Fax

Practice location:
  • Phone: 516-857-3723
  • Fax: 516-674-9031
Mailing address:
  • Phone: 516-857-3723
  • Fax: 516-674-9031

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: MR. GREGORY WILLIAM AGNEW
Title or Position: ACUPUNCTURIST
Credential: L.AC, LMT
Phone: 516-857-3733