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General NPI Number Information
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NPI Number | 1447864764
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Entity Type | Organization
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Legal Business Name | AKA MEDICAL WELLNESS AND AESTHETICS LLC
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 5801 WOODSIDE AVE
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City | WOODSIDE
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State | NY
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Zip | 11377-3437
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Country | US
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Telephone | 917-340-8997
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Fax |
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Provider Business Mailing Address
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Address Line | 250 1ST AVE APT 2B
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City | NEW YORK
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State | NY
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Zip | 10009-2612
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Country | US
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Telephone | 904-210-8025
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KARMITA CATIENZA
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Credential |
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Telephone | 904-210-8025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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