Provider Demographics
NPI:1164150348
Name:HAVEN ACUPUNCTURE
Entity Type:Organization
Organization Name:HAVEN ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUNCALI
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC
Authorized Official - Phone:845-728-3215
Mailing Address - Street 1:3 FELICELLO DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5609
Mailing Address - Country:US
Mailing Address - Phone:845-728-3215
Mailing Address - Fax:
Practice Address - Street 1:1510 ROUTE 9W STE 102
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-5425
Practice Address - Country:US
Practice Address - Phone:845-728-3215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty