MEDICARE: CHRISTINA DAWN MORRIS 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	1640	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P2640838	OTHER	NY	OXFORD PROVIDER #

General Provider Information

NPI Number	:	1255400693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA DAWN MORRIS L.AC.

Provider Business Mailing Address
First Line	:	518 HENRY ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-5243
Country	:	US
Telephone Number	:	718-855-4850
Fax Number	:	718-855-4860

Provider Business Practice Location Address
First Line	:	518 HENRY ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-5243
Country	:	US
Telephone Number	:	718-855-4850
Fax Number	:	718-855-4860

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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