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General NPI Number Information
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NPI Number | 1487926267
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE ASSOCIATES OF LONG ISLAND, P.C.
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 535 S BROADWAY SUITE 4
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City | HICKSVILLE
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State | NY
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Zip | 11801-5029
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Country | US
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Telephone | 516-513-1194
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Fax | 516-513-1195
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Provider Business Mailing Address
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Address Line | 535 S BROADWAY SUITE 4
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City | HICKSVILLE
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State | NY
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Zip | 11801-5029
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Country | US
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Telephone | 516-513-1194
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Fax | 516-513-1195
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Authorized Official
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Title or Position | OWNER, LICENSED ACUPUNCTURIST
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Name | MS. JODIE COLE
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Credential | L.AC.
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Telephone | 516-516-1194
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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 | 004075
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License Number State | NY
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