=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629271275
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACU. FEEL GOOD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2007
-----------------------------------------------------
Last Update Date | 12/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4345 44TH ST
-----------------------------------------------------
City | SUNNYSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11104-4607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-924-2269
-----------------------------------------------------
Fax | 718-652-1905
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3392 WAYNE AVE APT F 32
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10467-2419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-652-1905
-----------------------------------------------------
Fax | 718-652-1905
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST
-----------------------------------------------------
Name | DR. ILIANA COBELETA-ZILAHI
-----------------------------------------------------
Credential | M.D., MSTOM, L.AC.
-----------------------------------------------------
Telephone | 347-924-2269
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 002727
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------