Provider Demographics
NPI:1467207902
Name:VIBRANT LIGHT ACUPUNCTURE & MASSAGE, P.C.
Entity Type:Organization
Organization Name:VIBRANT LIGHT ACUPUNCTURE & MASSAGE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:516-353-2341
Mailing Address - Street 1:3 HAZELWOOD PLACE
Mailing Address - Street 2:APT 1
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:516-353-2341
Mailing Address - Fax:
Practice Address - Street 1:181 MAIN STREET
Practice Address - Street 2:SUITE 109
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:516-353-2341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty