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General NPI Number Information
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NPI Number | 1205340254
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Entity Type | Organization
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Legal Business Name | BED STUY ACUPUNCTURE AND MASSAGE THERAPY PLLC
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 1069 BEDFORD AVE STOREFRONT
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City | BROOKLYN
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State | NY
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Zip | 11216
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Country | US
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Telephone | 862-252-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 1069 BEDFORD AVE STOREFRONT
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City | BROOKLYN
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State | NY
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Zip | 11216-4793
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Country | US
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Telephone | 862-252-1230
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Fax |
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Authorized Official
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Title or Position | OWNER, SENIOR ACUPUNCTURIST
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Name | KATHERINE O'NEAL HENDERSON
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Credential | LAC
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Telephone | 917-282-7208
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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 | 003500
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License Number State | NY
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