Provider Demographics
NPI:1851801393
Name:BLUESTONE ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:BLUESTONE ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNER TOOHEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DAOM
Authorized Official - Phone:845-986-7860
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:CLARYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12725-0023
Mailing Address - Country:US
Mailing Address - Phone:845-986-7860
Mailing Address - Fax:
Practice Address - Street 1:44 WEST ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1435
Practice Address - Country:US
Practice Address - Phone:845-986-7860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3533-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1750550182Medicaid