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General NPI Number Information
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NPI Number | 1356452130
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Entity Type | Individual
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Provider Name | TRACY FITZ L.AC., MSTOM
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 531A 6TH AVE PARLOR FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11215-4908
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Country | US
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Telephone | 347-531-2320
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Fax | 718-768-8161
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Provider Business Mailing Address
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Address Line | 531A 6TH AVE PARLOR FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11215-4908
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Country | US
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Telephone | 347-531-2320
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Fax | 718-768-8161
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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 | 001355-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 091-0000077
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 629
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1754
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License Number State | FL
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