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General NPI Number Information
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NPI Number | 1952860645
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Entity Type | Organization
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Legal Business Name | EAST MEETS WEST ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 16 SQUADRON BLVD
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City | NEW CITY
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State | NY
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Zip | 10956-5259
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Country | US
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Telephone | 800-750-8616
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Fax | 845-362-8474
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Provider Business Mailing Address
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Address Line | 16 SQUADRON BLVD
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City | NEW CITY
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State | NY
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Zip | 10956-5259
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Country | US
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Telephone | 800-750-8616
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Fax | 845-362-8474
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Authorized Official
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Title or Position | OWNER
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Name | GRACE MINELLA
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Credential | LAC
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Telephone | 551-587-2287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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