Provider Demographics
NPI:1578268819
Name:AVENUE ACUPUNCTURE, PLLC.
Entity Type:Organization
Organization Name:AVENUE ACUPUNCTURE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:518-569-6275
Mailing Address - Street 1:76 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2925
Mailing Address - Country:US
Mailing Address - Phone:518-569-6275
Mailing Address - Fax:
Practice Address - Street 1:76 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2925
Practice Address - Country:US
Practice Address - Phone:518-569-6275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty