Provider Demographics
NPI:1568825305
Name:EAST VILLAGE COMMUNITY ACUPNCTURE
Entity Type:Organization
Organization Name:EAST VILLAGE COMMUNITY ACUPNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:NIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-853-2644
Mailing Address - Street 1:225 E 4TH ST APT 24
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7226
Mailing Address - Country:US
Mailing Address - Phone:646-853-2644
Mailing Address - Fax:
Practice Address - Street 1:225 E 4TH ST APT 24
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7226
Practice Address - Country:US
Practice Address - Phone:646-853-2644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005635-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty