Healthcare Provider Details

I. General information

NPI: 1043824162
Provider Name (Legal Business Name): ANDRE X PRESSLEY L.AC, LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SPRUCE PL
MELVILLE NY
11747-1104
US

IV. Provider business mailing address

20 HAUSCH BLVD
ROOSEVELT NY
11575-1533
US

V. Phone/Fax

Practice location:
  • Phone: 631-855-5198
  • Fax:
Mailing address:
  • Phone: 631-855-5198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007360
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number031981-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: