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NPI 1861137911

NPI 1861137911 : MELVILLE ACUPUNCTURE AND MASSAGE P.C. : MELVILLE, NY

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General NPI Number Information
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    NPI Number           |    1861137911
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    Entity Type          |    Organization 
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    Legal Business Name  |    MELVILLE ACUPUNCTURE AND MASSAGE P.C. 
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Dates
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    Enumeration Date     |    05/03/2022
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    Last Update Date     |    05/03/2022
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Provider Practice Location Address
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    Address Line         |    115 BROADHOLLOW RD STE 10 
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    City                 |    MELVILLE
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    State                |    NY
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    Zip                  |    11747-4992
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    Country              |    US
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    Telephone            |    631-969-6422
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    103 CONNECTICUT AVE 
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    City                 |    BAY SHORE
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    State                |    NY
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    Zip                  |    11706-3246
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    Country              |    US
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    Telephone            |    631-969-6422
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SAUL JUNIOR ALVAREZ 
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    Credential           |    LAC, LMT
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    Telephone            |    631-969-6422
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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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Taxonomy #2
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    
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    License Number State |    
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