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General NPI Number Information
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NPI Number | 1023604733
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Entity Type | Individual
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Provider Name | TIMOTHY JOSEPH CARRATU L.AC
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Gender | Male
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 185 MERRICK RD STE 2D
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City | LYNBROOK
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State | NY
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Zip | 11563-2787
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Country | US
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Telephone | 516-274-7891
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Fax |
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Provider Business Mailing Address
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Address Line | 111 DAFFODIL AVE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3701
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Country | US
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Telephone | 516-784-9608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 006780
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License Number State | NY
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