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General NPI Number Information
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NPI Number | 1730363839
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Entity Type | Individual
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Provider Name | SUSAN LEE SHELDON R.D., M.S., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 6280 ROUTE 96 SUITE C
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City | VICTOR
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State | NY
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Zip | 14564-1408
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Country | US
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Telephone | 315-246-8342
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Fax |
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Provider Business Mailing Address
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Address Line | 1663 BLACK BROOK ROAD
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City | SENECA FALLS
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State | NY
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Zip | 13148-9721
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Country | US
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Telephone | 315-246-8342
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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 | 003420
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License Number State | NY
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