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General NPI Number Information
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NPI Number | 1669789996
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Entity Type | Individual
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Provider Name | DEIRDRE CORRIGAN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 39-89 50TH ST. APT. 1E
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City | WOODSIDE
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State | NY
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Zip | 11377
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Country | US
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Telephone | 917-882-4698
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Fax |
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Provider Business Mailing Address
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Address Line | 2611 ROUTE 145
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City | PRESTON HOLLOW
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State | NY
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Zip | 12469
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Country | US
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Telephone | 917-882-4698
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0042891
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License Number State | NY
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