MEDICARE: ALEXA VULPIS 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	006518	NY

General Provider Information

NPI Number	:	1720731243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA VULPIS L.AC

Provider Business Mailing Address
First Line	:	15 CRAWFORD RD
Second Line	:
City	:	MANALAPAN
State	:	NJ
Zip	:	07726-8394
Country	:	US
Telephone Number	:	908-839-6228
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 HUGUENOT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4312
Country	:	US
Telephone Number	:	646-434-8090
Fax Number	:

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

Provider Enumeration Date	:	02/03/2022
Last Update Date	:	02/03/2022

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