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General NPI Number Information
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NPI Number | 1689339467
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Entity Type | Organization
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Legal Business Name | KAYLA TRICARICO ACUPUNCTURE PC
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 786 MONTAUK HWY
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City | WEST ISLIP
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State | NY
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Zip | 11795-4926
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Country | US
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Telephone | 631-661-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 207 AVENUE A
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City | RONKONKOMA
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State | NY
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Zip | 11779-1907
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Country | US
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Telephone | 631-235-3686
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAYLA TRICARICO
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Credential |
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Telephone | 631-235-3686
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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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