Provider Demographics
NPI:1598082190
Name:DELROSAL, ANA VICTORIA (MSAC, LAC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:VICTORIA
Last Name:DELROSAL
Suffix:
Gender:F
Credentials:MSAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 E 11TH ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6811
Mailing Address - Country:US
Mailing Address - Phone:786-302-0153
Mailing Address - Fax:201-222-6755
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:786-302-0153
Practice Address - Fax:201-222-6755
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist