Provider Demographics
NPI:1225350762
Name:AMITYVILLE ACUPUNCTURE & MASSAGE
Entity Type:Organization
Organization Name:AMITYVILLE ACUPUNCTURE & MASSAGE
Other - Org Name:AMITYVILLE ACUPUNCTURE & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURME
Authorized Official - Suffix:
Authorized Official - Credentials:MSTOM, LAC, LMT
Authorized Official - Phone:631-691-0200
Mailing Address - Street 1:134 BROADWAY
Mailing Address - Street 2:A
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2771
Mailing Address - Country:US
Mailing Address - Phone:631-691-0200
Mailing Address - Fax:631-691-0202
Practice Address - Street 1:134 BROADWAY
Practice Address - Street 2:A
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2771
Practice Address - Country:US
Practice Address - Phone:631-691-0200
Practice Address - Fax:631-691-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37031261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service