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General NPI Number Information
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NPI Number | 1447701651
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Entity Type | Individual
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Provider Name | GRACE ZUCCARO MINNELLA MS., L.AC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2016
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Last Update Date | 10/23/2016
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Provider Practice Location Address
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Address Line | 345 N MAIN ST SUITE #10
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City | NEW CITY
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State | NY
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Zip | 10956-4305
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Country | US
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Telephone | 551-587-2287
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Fax |
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Provider Business Mailing Address
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Address Line | 173 WERIMUS RD
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677-7713
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Country | US
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Telephone | 551-587-2287
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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 | 002196-1
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License Number State | NY
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