Provider Demographics
NPI:1457753782
Name:ACUPUNCTURE HEALTH CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:ACUPUNCTURE HEALTH CARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:845-255-7178
Mailing Address - Street 1:108 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1517
Mailing Address - Country:US
Mailing Address - Phone:845-255-7178
Mailing Address - Fax:
Practice Address - Street 1:108 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1517
Practice Address - Country:US
Practice Address - Phone:845-255-7178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000514171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1811950835OtherNPI
1134290711OtherNPI