Healthcare Provider Details

I. General information

NPI: 1053832337
Provider Name (Legal Business Name): ALIGN ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W 28TH ST STE 5R
NEW YORK NY
10001-6410
US

IV. Provider business mailing address

119 8TH ST STE 205
BROOKLYN NY
11215-3161
US

V. Phone/Fax

Practice location:
  • Phone: 415-706-6656
  • Fax:
Mailing address:
  • Phone: 415-706-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005575
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AIMEE DERBES
Title or Position: OWNER, ORIGINAL MEMBER
Credential: DACM, LAC
Phone: 415-706-6656