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General NPI Number Information
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NPI Number | 1053068106
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Entity Type | Organization
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Legal Business Name | SAGESTONE
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 105 GRAND ST
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City | BROOKLYN
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State | NY
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Zip | 11249-4123
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Country | US
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Telephone | 914-246-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 119 PONDFIELD RD UNIT 911
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City | BRONXVILLE
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State | NY
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Zip | 10708-7642
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Country | US
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Telephone | 914-246-2633
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | DR. PEARL LAWSON
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Credential |
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Telephone | 914-246-2633
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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 |
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License Number State |
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