Provider Demographics
NPI:1205236585
Name:BEFFA, ELYSE (DIPL OF OM, LAC)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:BEFFA
Suffix:
Gender:F
Credentials:DIPL OF OM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 SE MAYNARD RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3634
Mailing Address - Country:US
Mailing Address - Phone:919-395-2291
Mailing Address - Fax:
Practice Address - Street 1:1350 SE MAYNARD RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3634
Practice Address - Country:US
Practice Address - Phone:919-395-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC615171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist