Provider Demographics
NPI:1609417492
Name:ESSENTIAL POINTS ACUPUNCTURE
Entity Type:Organization
Organization Name:ESSENTIAL POINTS ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:631-838-1686
Mailing Address - Street 1:15 DICKERSON AVE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-1127
Mailing Address - Country:US
Mailing Address - Phone:631-838-1686
Mailing Address - Fax:
Practice Address - Street 1:170 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:631-838-1686
Practice Address - Fax:631-689-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty