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General NPI Number Information
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NPI Number | 1346623527
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Entity Type | Individual
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Provider Name | HAROLDO JEZLER L.AC.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 180 S BROADWAY STE 300
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1841
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Country | US
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Telephone | 914-320-5239
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Fax |
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Provider Business Mailing Address
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Address Line | 145 MILTON RD
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City | RYE
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State | NY
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Zip | 10580-3812
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Country | US
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Telephone | 914-320-5239
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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 | 005592
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License Number State | NY
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