Provider Demographics
NPI:1588176903
Name:WINDHORSE ACUPUNCTURE
Entity Type:Organization
Organization Name:WINDHORSE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HABEREK- WINDHORSE
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:518-524-1141
Mailing Address - Street 1:PO BOX 1624
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-5624
Mailing Address - Country:US
Mailing Address - Phone:518-524-1141
Mailing Address - Fax:
Practice Address - Street 1:107 HAND AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-524-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004260-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty