Healthcare Provider Details

I. General information

NPI: 1720731243
Provider Name (Legal Business Name): ALEXA VULPIS L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 HUGUENOT AVE
STATEN ISLAND NY
10312-4312
US

IV. Provider business mailing address

15 CRAWFORD RD
MANALAPAN NJ
07726-8394
US

V. Phone/Fax

Practice location:
  • Phone: 646-434-8090
  • Fax:
Mailing address:
  • Phone: 908-839-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: