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General NPI Number Information
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NPI Number | 1609417492
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Entity Type | Organization
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Legal Business Name | ESSENTIAL POINTS ACUPUNCTURE
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 170 25A
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City | ROCKY POINT
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State | NY
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Zip | 11778
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Country | US
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Telephone | 631-838-1686
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Fax | 631-689-1664
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Provider Business Mailing Address
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Address Line | 15 DICKERSON AVE
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City | STONY BROOK
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State | NY
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Zip | 11790-1127
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Country | US
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Telephone | 631-838-1686
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA DODD
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Credential | LAC
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Telephone | 631-838-1686
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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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