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NPI Code Detail

MEDICARE: ORLY NAVARO LAC

MEDICARE:   ORLY  NAVARO  LAC
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
1171100000XAcupuncturist0035671NY

General Provider Information

NPI Number : 1063696904
Entity Type Code : Individual
Provider Name (Legal Business Name) : ORLY NAVARO LAC
Provider Business Mailing Address
First Line : 93 WALCOTT AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6311
Country : US
Telephone Number : 718-354-5196
Fax Number :
Provider Business Practice Location Address
First Line : 93 WALCOTT AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314
Country : US
Telephone Number : 718-494-0365
Fax Number : 718-494-0365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2007
Last Update Date : 02/24/2026

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Directions to “ ORLY NAVARO LAC” Practice Location

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