Healthcare Provider Details

I. General information

NPI: 1114841673
Provider Name (Legal Business Name): KATRINA PIETROWICZ L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 W 109TH ST APT 5R
NEW YORK NY
10025-2585
US

IV. Provider business mailing address

172 W 109TH ST APT 5R
NEW YORK NY
10025-2585
US

V. Phone/Fax

Practice location:
  • Phone: 201-400-2383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007965
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: