Provider Demographics
NPI:1003347741
Name:ELYSIUM ACUPUNCTURE PC
Entity Type:Organization
Organization Name:ELYSIUM ACUPUNCTURE PC
Other - Org Name:NATURNA INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:OMD, LAC
Authorized Official - Phone:917-341-3562
Mailing Address - Street 1:129 E 90TH ST
Mailing Address - Street 2:1W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1568
Mailing Address - Country:US
Mailing Address - Phone:646-609-4250
Mailing Address - Fax:
Practice Address - Street 1:129 E 90TH ST
Practice Address - Street 2:1W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1568
Practice Address - Country:US
Practice Address - Phone:646-609-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004772-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty