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General NPI Number Information
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NPI Number | 1548040702
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Entity Type | Organization
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Legal Business Name | GENWELL ACUPUNCTURE, PLLC
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 378 ROUTE 202
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City | SOMERS
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State | NY
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Zip | 10589-3248
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Country | US
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Telephone | 646-483-3086
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Fax |
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Provider Business Mailing Address
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Address Line | 37 DAVID RD
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City | SOMERS
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State | NY
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Zip | 10589-3009
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Country | US
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Telephone | 646-483-3086
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TARA ALMQUIST
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Credential | DAIM, L.AC.
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Telephone | 646-483-3086
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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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