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NPI Code Detail

MEDICARE: GREGG R ST.CLAIR L.AC.

MEDICARE: GREGG R ST.CLAIR 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
1171100000XAcupuncturist001933-1NY

General Provider Information

NPI Number : 1184978538
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGG R ST.CLAIR L.AC.
Provider Business Mailing Address
First Line : 6 CHELSEA PL
Second Line :
City : CLIFTON PARK
State : NY
Zip : 12065-3216
Country : US
Telephone Number : 518-383-1230
Fax Number :
Provider Business Practice Location Address
First Line : 6 CHELSEA PL
Second Line :
City : CLIFTON PARK
State : NY
Zip : 12065-3216
Country : US
Telephone Number : 518-383-1230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2012
Last Update Date : 11/07/2012

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Directions to “ GREGG R ST.CLAIR L.AC.” Practice Location

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