MEDICARE: MS. MONE THERESA CITRO DIPL. 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	5402000282	MI

General Provider Information

NPI Number	:	1467282582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONE THERESA CITRO DIPL. AC.

Provider Business Mailing Address
First Line	:	1280 RUGBY CIR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0944
Country	:	US
Telephone Number	:	909-754-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	1280 RUGBY CIR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0944
Country	:	US
Telephone Number	:	909-754-8065
Fax Number	:

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

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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