Healthcare Provider Details

I. General information

NPI: 1023576535
Provider Name (Legal Business Name): ADINA MOLDOVAN L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 S OYSTER BAY RD UNIT B
PLAINVIEW NY
11803-3321
US

IV. Provider business mailing address

39 HOPE DR
PLAINVIEW NY
11803-5625
US

V. Phone/Fax

Practice location:
  • Phone: 516-849-8602
  • Fax:
Mailing address:
  • Phone: 516-849-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006456
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: