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General NPI Number Information
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NPI Number | 1467600320
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Entity Type | Organization
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Legal Business Name | SLEEPY HOLLOW ACUPUNCTURE LLC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 239 N BROADWAY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2674
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Country | US
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Telephone | 914-819-0970
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Fax | 914-487-8309
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Provider Business Mailing Address
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Address Line | 239 N BROADWAY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2674
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Country | US
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Telephone | 914-819-0970
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Fax | 914-487-8309
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER WILLIAM TRICARICO
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Credential | L.AC.
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Telephone | 914-819-0970
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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 | 003328
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License Number State | NY
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