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General NPI Number Information
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NPI Number | 1528951415
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Entity Type | Organization
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Legal Business Name | SCOTT GRALLA ACUPUNCTURE LLC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 755 PULASKI RD
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City | GREENLAWN
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State | NY
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Zip | 11740-1710
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Country | US
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Telephone | 631-754-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CORNFIELD LN
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City | COMMACK
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State | NY
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Zip | 11725-2702
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Country | US
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Telephone | 516-987-1926
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. SCOTT MICHAEL GRALLA
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Credential | L.AC.
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Telephone | 516-987-1926
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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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