Provider Demographics
NPI:1235797895
Name:SIGNATURE ACUPUNCTURE STUDIO PLLC
Entity Type:Organization
Organization Name:SIGNATURE ACUPUNCTURE STUDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:914-222-5644
Mailing Address - Street 1:277 MARTINE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3401
Mailing Address - Country:US
Mailing Address - Phone:914-222-5644
Mailing Address - Fax:
Practice Address - Street 1:277 MARTINE AVE STE 207
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3401
Practice Address - Country:US
Practice Address - Phone:914-222-5644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty