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General NPI Number Information
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NPI Number | 1629938840
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Entity Type | Organization
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Legal Business Name | STEFANIE VIDAL ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 16 QUAKER AVE STOP 5
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City | CORNWALL
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State | NY
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Zip | 12518-2113
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Country | US
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Telephone | 917-684-6743
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SHELDON DR
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City | CORNWALL
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State | NY
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Zip | 12518-1614
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Country | US
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Telephone | 917-684-6743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEFANIE VIDAL
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Credential | LAC
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Telephone | 917-684-6743
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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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