Provider Demographics
NPI:1568806347
Name:RICON DE ACUPUNTURA, PC
Entity Type:Organization
Organization Name:RICON DE ACUPUNTURA, PC
Other - Org Name:ACACIA NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:LIC ACUPUNCTURIST
Authorized Official - Phone:718-960-7656
Mailing Address - Street 1:308 E 175TH ST
Mailing Address - Street 2:BASEMENT
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5804
Mailing Address - Country:US
Mailing Address - Phone:917-232-0474
Mailing Address - Fax:
Practice Address - Street 1:308 E 175TH ST
Practice Address - Street 2:BASEMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5804
Practice Address - Country:US
Practice Address - Phone:917-232-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000806171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty