MEDICARE: CHI LEE DIGRAZIA

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	225700000X	Massage Therapist	015997-1	NY
2	171100000X	Acupuncturist	006599-01

General Provider Information

NPI Number	:	1962044792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI LEE DIGRAZIA

Provider Business Mailing Address
First Line	:	165 W 66TH ST # 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-6508
Country	:	US
Telephone Number	:	212-689-4367
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 E 55TH ST FRNT
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4514
Country	:	US
Telephone Number	:	212-689-4367
Fax Number	:

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

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	10/14/2019

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Directions to “ CHI LEE DIGRAZIA ” Practice Location

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