Provider Demographics
NPI:1548387665
Name:IONA, MICHELLE N (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:N
Last Name:IONA
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 1:750 ROANOKE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2791
Mailing Address - Country:US
Mailing Address - Phone:631-653-5314
Mailing Address - Fax:
Practice Address - Street 1:750 ROANOKE AVE STE D
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2791
Practice Address - Country:US
Practice Address - Phone:631-653-5314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1629OtherACUPUNCTURE LICENSE NUMBE