Provider Demographics
NPI:1255760682
Name:FEMMINELLA, EKATERINA (ACUPUNCTURIST, MASSA)
Entity type:Individual
Prefix:MRS
First Name:EKATERINA
Middle Name:
Last Name:FEMMINELLA
Suffix:
Gender:F
Credentials:ACUPUNCTURIST, MASSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6918
Mailing Address - Country:US
Mailing Address - Phone:646-431-9838
Mailing Address - Fax:
Practice Address - Street 1:181 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:646-431-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003125-1171100000X
NY022678-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherMAJOR MEDICAL