Healthcare Provider Details

I. General information

NPI: 1538556519
Provider Name (Legal Business Name): ORBIT ACUPUNCTURE P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2052 RICHMOND RD
STATEN ISLAND NY
10306-2583
US

IV. Provider business mailing address

2052 RICHMOND RD
STATEN ISLAND NY
10306-2583
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-2160
  • Fax: 718-667-7279
Mailing address:
  • Phone: 718-351-2160
  • Fax: 718-667-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number001884
License Number StateNY

VIII. Authorized Official

Name: MAGDY MOHAMMED ELMADBOLY
Title or Position: DIRECTOR
Credential: ACUPUNCTURIST
Phone: 718-351-2160