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General NPI Number Information
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NPI Number | 1821381476
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Entity Type | Organization
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Legal Business Name | EASTGATE ACUPUNCTURE P.C.
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 454 WARREN ST APT 3
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City | HUDSON
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State | NY
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Zip | 12534-2445
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Country | US
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Telephone | 518-828-0205
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Fax | 646-224-8399
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Provider Business Mailing Address
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Address Line | 177 E HARTSDALE AVE SUITE LLA
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City | HARTSDALE
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State | NY
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Zip | 10530-3543
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Country | US
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Telephone | 914-713-1000
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Fax | 914-713-1020
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Authorized Official
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Title or Position | OWNER
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Name | CRYSTAL DMYTRYK
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Credential | L.AC.
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Telephone | 914-713-1000
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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 | 004451
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License Number State | NY
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