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NPI Code Detail

MEDICARE: OPTIMUM HEALTH ACUPUNCTURE, P.C.

MEDICARE: OPTIMUM HEALTH ACUPUNCTURE, P.C.
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
1171100000XAcupuncturist

General Provider Information

NPI Number : 1992302087
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMUM HEALTH ACUPUNCTURE, P.C.
Provider Business Mailing Address
First Line : 6336 99TH ST FL 1
Second Line :
City : REGO PARK
State : NY
Zip : 11374-1979
Country : US
Telephone Number : 718-509-9424
Fax Number : 718-509-9242
Provider Business Practice Location Address
First Line : 1963 GRAND CONCOURSE FL 2
Second Line :
City : BRONX
State : NY
Zip : 10453-4995
Country : US
Telephone Number : 718-509-9424
Fax Number :
Authorized Official
Title or Position : OWNER
Name : VADIM DOLSKY
Credential : LAC
Telephone Number : 718-974-3284
Provider Enumeration Date : 10/02/2020
Last Update Date : 11/27/2023

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