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General NPI Number Information
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NPI Number | 1144681826
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Entity Type | Organization
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Legal Business Name | KAIROS ACUPUNCTURE
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 303 5TH AVE RM 1209
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City | NEW YORK
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State | NY
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Zip | 10016-6648
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Country | US
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Telephone | 646-982-9296
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Fax |
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Provider Business Mailing Address
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Address Line | 363 3RD AVE APT 1A
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City | NEW YORK
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State | NY
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Zip | 10016-9070
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Country | US
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Telephone | 646-982-9296
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY KLEMT
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Credential | L.AC.
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Telephone | 646-982-9296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 005408
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License Number State | NY
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