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General NPI Number Information
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NPI Number | 1518506609
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE FOR ATHLETES PLLC
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 124 E 40TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-1723
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Country | US
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Telephone | 929-992-0935
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Fax |
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Provider Business Mailing Address
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Address Line | 124 E 40TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-1723
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Country | US
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Telephone | 929-992-0935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. COLLEEN CANYON
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Credential | MS, L.AC.
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Telephone | 929-992-0935
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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 |
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License Number State |
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