Provider Demographics
NPI:1083123327
Name:ROSENBAUM, ABBY PALOMA (DACM, LAC)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:PALOMA
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W 22ND ST FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5142
Mailing Address - Country:US
Mailing Address - Phone:212-686-3101
Mailing Address - Fax:
Practice Address - Street 1:7 W 22ND ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5142
Practice Address - Country:US
Practice Address - Phone:212-686-3101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006076171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty