MEDICARE: PATRICIA ANNE ORELLANA L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	002572	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83Q461	OTHER	NY	BCBS

General Provider Information

NPI Number	:	1003977273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANNE ORELLANA L.AC

Provider Business Mailing Address
First Line	:	114-11 135 AVE
Second Line	:	2ND FLOOR
City	:	SOUTH OZONE PARK
State	:	NY
Zip	:	11420
Country	:	US
Telephone Number	:	718-845-8788
Fax Number	:

Provider Business Practice Location Address
First Line	:	11420 ROCKAWAY BLVD
Second Line	:
City	:	SOUTH OZONE PARK
State	:	NY
Zip	:	11420-1912
Country	:	US
Telephone Number	:	917-660-1699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	03/03/2023

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