Provider Demographics
NPI:1417678335
Name:CAC ACUPUNCTURE PC
Entity Type:Organization
Organization Name:CAC ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CAPURSO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:631-402-4680
Mailing Address - Street 1:18 NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-1228
Mailing Address - Country:US
Mailing Address - Phone:631-402-3291
Mailing Address - Fax:631-980-7966
Practice Address - Street 1:1147 DEER PARK AVE UNIT A
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3103
Practice Address - Country:US
Practice Address - Phone:631-667-8154
Practice Address - Fax:631-980-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty