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General NPI Number Information
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NPI Number | 1114740586
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Entity Type | Individual
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Provider Name | KIRSTIN BUNTON LAC
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 69 W 71ST ST
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City | NEW YORK
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State | NY
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Zip | 10023-4112
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Country | US
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Telephone | 845-614-3243
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Fax |
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Provider Business Mailing Address
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Address Line | 116 PERRY ST APT J56
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City | NEW YORK
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State | NY
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Zip | 10014-2353
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Country | US
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Telephone | 971-664-3210
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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 | 007304-01
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License Number State | NY
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