Healthcare Provider Details

I. General information

NPI: 1306254990
Provider Name (Legal Business Name): ANDREA CONTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2014
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 ROSEVALE AVE
RONKONKOMA NY
11779-3036
US

IV. Provider business mailing address

352 ROSEVALE AVE
RONKONKOMA NY
11779-3036
US

V. Phone/Fax

Practice location:
  • Phone: 631-682-9853
  • Fax: 631-619-1895
Mailing address:
  • Phone: 631-682-9853
  • Fax: 631-619-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005650
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number025341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: