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General NPI Number Information
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NPI Number | 1144550179
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Entity Type | Organization
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Legal Business Name | CLASSICAL FIVE-ELEMENT ACUPUNCTURE
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 3200 BRIGHTON HENRIETTA TL RD
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City | ROCHESTER
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State | NY
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Zip | 14623-2754
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Country | US
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Telephone | 585-242-9518
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Fax | 585-242-9073
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Provider Business Mailing Address
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Address Line | 3200 BRIGHTON HENRIETTA TL RD
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City | ROCHESTER
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State | NY
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Zip | 14623-2754
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Country | US
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Telephone | 585-242-9518
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Fax | 585-242-9073
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Authorized Official
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Title or Position | OWNER
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Name | MS. DIANE TERESE MACCHIAVELLI
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Credential | L.AC.
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Telephone | 585-242-9518
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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 | 001159-1
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License Number State | NY
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