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General NPI Number Information
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NPI Number | 1356225536
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Entity Type | Organization
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Legal Business Name | VITALITY ACUPUNCTURE LLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 260 GATEWAY DR STE 9-10C
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 215-687-3095
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 DUBLIN MANOR RD
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City | STREET
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State | MD
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Zip | 21154-1925
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Country | US
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Telephone | 215-687-3095
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | SOFIYA SYDORYAK
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Credential | L.AC.
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Telephone | 215-687-3095
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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 |
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License Number State |
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