Healthcare Provider Details

I. General information

NPI: 1558839092
Provider Name (Legal Business Name): INGA FRUMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 FRANKLIN AVE
HEWLETT NY
11557-2016
US

IV. Provider business mailing address

83 WOOD LN
WOODMERE NY
11598-2232
US

V. Phone/Fax

Practice location:
  • Phone: 516-837-0070
  • Fax:
Mailing address:
  • Phone: 516-395-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number002324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: