=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538533328
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUVOTION HEALTH ACUPUNCTURE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2015
-----------------------------------------------------
Last Update Date | 11/17/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 168 W 86TH ST SUITE 1BW
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10024-4022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-588-1573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 W 89TH ST APT 10G
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10024-1805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-588-1573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | VERONICA HAGQUIST
-----------------------------------------------------
Credential | L.AC.
-----------------------------------------------------
Telephone | 646-588-1573
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 005520
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------