Healthcare Provider Details

I. General information

NPI: 1437749645
Provider Name (Legal Business Name): NEW YORK ACUPUNCTURE & MASSAGE THERAPYPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 W 23RD ST STE 701
NEW YORK NY
10011-6348
US

IV. Provider business mailing address

825 W 187TH ST APT 7C
NEW YORK NY
10033-1216
US

V. Phone/Fax

Practice location:
  • Phone: 631-905-6870
  • Fax: 212-924-4692
Mailing address:
  • Phone: 631-905-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER GIORDANO
Title or Position: PRESIDENT
Credential: LAC
Phone: 631-905-6870