MEDICARE: VANESSA VARTOLO 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	002343-1	NY

General Provider Information

NPI Number	:	1093885865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA VARTOLO L.AC.

Provider Business Mailing Address
First Line	:	1032 84TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2926
Country	:	US
Telephone Number	:	917-697-3536
Fax Number	:	718-876-6143

Provider Business Practice Location Address
First Line	:	6931 3RD AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1304
Country	:	US
Telephone Number	:	917-697-3536
Fax Number	:	718-876-6143

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	04/11/2024

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