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General NPI Number Information
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NPI Number | 1902626559
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Entity Type | Individual
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Provider Name | DAVID C MAINENTI L. AC., DIPL. O.M.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 192 GLEN ST
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City | GLEN COVE
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State | NY
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Zip | 11542-2710
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Country | US
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Telephone | 516-548-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 111 BALDWIN AVE
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City | LOCUST VALLEY
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State | NY
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Zip | 11560-1904
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Country | US
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Telephone | 516-801-4837
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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 | 007560
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License Number State | NY
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