MEDICARE: JAMES M. SHINOL, ACUPUNCTURE, PC

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	002654	NY

General Provider Information

NPI Number	:	1114291804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES M. SHINOL, ACUPUNCTURE, PC

Provider Business Mailing Address
First Line	:	650 HAWKINS AVE
Second Line	:	SUITE 4
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-2366
Country	:	US
Telephone Number	:	631-981-7422
Fax Number	:	631-981-2490

Provider Business Practice Location Address
First Line	:	650 HAWKINS AVE
Second Line	:	SUITE 4
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-2366
Country	:	US
Telephone Number	:	631-981-7422
Fax Number	:	631-981-2490

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JAMES MICHAEL SHINOL
Credential	:	L.AC.
Telephone Number	:	516-509-5444

Provider Enumeration Date	:	02/28/2012
Last Update Date	:	02/28/2012

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