Healthcare Provider Details

I. General information

NPI: 1326495458
Provider Name (Legal Business Name): ANDREW MOREJON L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ANDREW MOREJON L.AC

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WESTCHESTER PARK DR
WEST HARRISON NY
10604-3426
US

IV. Provider business mailing address

163 COLIGNI AVE
NEW ROCHELLE NY
10801-2414
US

V. Phone/Fax

Practice location:
  • Phone: 914-755-1806
  • Fax:
Mailing address:
  • Phone: 914-755-1806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006775
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0291161
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: