Provider Demographics
NPI:1518275312
Name:FUGELSANG, CATHERINE A (DACM, LAC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:FUGELSANG
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 AINSLIE ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4929
Mailing Address - Country:US
Mailing Address - Phone:347-585-9097
Mailing Address - Fax:
Practice Address - Street 1:240 AINSLIE ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-4929
Practice Address - Country:US
Practice Address - Phone:347-585-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004351171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist