Healthcare Provider Details
I. General information
NPI: 1073105813
Provider Name (Legal Business Name): FLY AGAIN ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 MAIN ST
GREENWICH NY
12834-1211
US
IV. Provider business mailing address
70 MAIN ST
GREENWICH NY
12834-1211
US
V. Phone/Fax
- Phone: 518-232-1759
- Fax: 518-633-1794
- Phone: 518-232-1759
- Fax: 518-633-1794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALYCIA
V
ASKEW
Title or Position: OWNER/ACUPUNCTURIST
Credential: L.AC.
Phone: 518-232-1759