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General NPI Number Information
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NPI Number | 1336679281
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Entity Type | Individual
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Provider Name | MAITTES LEE ROMERO ACUPUNCTURIST
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 9411 JAMAICA AVE FL 1
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City | WOODHAVEN
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State | NY
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Zip | 11421-2222
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Country | US
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Telephone | 718-849-9696
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Fax |
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Provider Business Mailing Address
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Address Line | 10 WHISPERING FIELDS DR
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City | NORTHPORT
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State | NY
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Zip | 11768-2866
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Country | US
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Telephone | 631-912-0680
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Fax | 631-912-9056
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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 | 005871-1
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License Number State | NY
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