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General NPI Number Information
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NPI Number | 1689345456
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Entity Type | Individual
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Provider Name | KRISTEN FISCHBACH
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 354 VETERANS MEMORIAL HWY STE 1
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City | COMMACK
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State | NY
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Zip | 11725-4331
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Country | US
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Telephone | 631-326-4286
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Fax |
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Provider Business Mailing Address
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Address Line | 11 GLEN HOLLOW DR APT D61
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City | HOLTSVILLE
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State | NY
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Zip | 11742-2456
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Country | US
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Telephone | 631-681-2370
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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 | 006998
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License Number State | NY
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