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General NPI Number Information
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NPI Number | 1609326438
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Entity Type | Organization
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Legal Business Name | UNION STREET ACUPUNCTURE PC
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 790A UNION ST
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City | BROOKLYN
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State | NY
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Zip | 11215-1307
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Country | US
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Telephone | 347-987-4399
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Fax | 347-987-4373
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Provider Business Mailing Address
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Address Line | 790A UNION ST
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City | BROOKLYN
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State | NY
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Zip | 11215-1307
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Country | US
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Telephone | 347-987-4399
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Fax | 347-987-4373
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Authorized Official
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Title or Position | OWNER
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Name | MS. LISA METZGER
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Credential | LAC
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Telephone | 419-618-1928
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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 | 003955
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License Number State | NY
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