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General NPI Number Information
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NPI Number | 1265241426
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Entity Type | Individual
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Provider Name | JESSICA PAIGE NAGLER L.AC
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Gender | Female
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 880 N BROADWAY
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City | MASSAPEQUA
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State | NY
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Zip | 11758-2351
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Country | US
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Telephone | 516-200-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 17 INDIAN RUN
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City | EAST QUOGUE
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State | NY
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Zip | 11942-4947
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Country | US
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Telephone |
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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 | 007573
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License Number State | NY
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