MEDICARE: CHRISTINA ANNE HABEREK-WINDHORSE LIC. 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	004260-1	NY

General Provider Information

NPI Number	:	1649716168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ANNE HABEREK-WINDHORSE LIC. AC

Provider Business Mailing Address
First Line	:	PO BOX 1624
Second Line	:
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-5624
Country	:	US
Telephone Number	:	518-524-1141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1996 SARANAC AVE
Second Line	:
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-1140
Country	:	US
Telephone Number	:	518-524-1141
Fax Number	:

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

Provider Enumeration Date	:	01/07/2017
Last Update Date	:	01/07/2017

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