Healthcare Provider Details

I. General information

NPI: 1700119617
Provider Name (Legal Business Name): ELISE JOY GREENBERG ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 THORNTON WAY APT 539
ALEXANDRIA VA
22314-6519
US

IV. Provider business mailing address

750 THORNTON WAY APT 539
ALEXANDRIA VA
22314-6519
US

V. Phone/Fax

Practice location:
  • Phone: 301-613-9297
  • Fax:
Mailing address:
  • Phone: 301-613-9297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000972
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: