MEDICARE: MS. MARIA ANTONIETTA ZARATE 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	003619-1	NY

General Provider Information

NPI Number	:	1497943443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA ANTONIETTA ZARATE L.AC.

Provider Business Mailing Address
First Line	:	2749 JACKSON AVE
Second Line	:	SUITE 1
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2924
Country	:	US
Telephone Number	:	718-361-8293
Fax Number	:	718-383-0853

Provider Business Practice Location Address
First Line	:	2749 JACKSON AVE
Second Line	:	SUITE 1
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2924
Country	:	US
Telephone Number	:	718-361-8293
Fax Number	:	718-383-0853

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

Provider Enumeration Date	:	10/03/2007
Last Update Date	:	10/03/2007

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