Provider Demographics
NPI:1093402570
Name:ORLY NAVARO LAC
Entity Type:Organization
Organization Name:ORLY NAVARO LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ORLY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-354-5196
Mailing Address - Street 1:93 WALCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6311
Mailing Address - Country:US
Mailing Address - Phone:718-354-5196
Mailing Address - Fax:
Practice Address - Street 1:93 WALCOTT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6311
Practice Address - Country:US
Practice Address - Phone:171-835-4519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty