Provider Demographics
NPI:1659032837
Name:ACUNICA ACUPUNCTURE PC
Entity Type:Organization
Organization Name:ACUNICA ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDIRKINA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-769-0478
Mailing Address - Street 1:215 BAY 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5469
Mailing Address - Country:US
Mailing Address - Phone:646-769-0478
Mailing Address - Fax:888-543-7447
Practice Address - Street 1:215 BAY 35TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5469
Practice Address - Country:US
Practice Address - Phone:646-769-0478
Practice Address - Fax:888-543-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1467790410OtherACUPUNCTURE