MEDICARE: MS. HELEN MONICA ROSLOW M.S., 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	2646	NY

General Provider Information

NPI Number	:	1760525497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HELEN MONICA ROSLOW M.S., L.AC.

Provider Business Mailing Address
First Line	:	12 IRMA AVE
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2810
Country	:	US
Telephone Number	:	516-883-8860
Fax Number	:	516-883-4130

Provider Business Practice Location Address
First Line	:	12 IRMA AVE
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2810
Country	:	US
Telephone Number	:	516-883-8860
Fax Number	:	516-883-4130

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	10/05/2010

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