Provider Demographics
NPI:1649661919
Name:SCARSDALE HEALTH & WELLNESS
Entity type:Organization
Organization Name:SCARSDALE HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DISTEFANO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:914-723-5105
Mailing Address - Street 1:778 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5005
Mailing Address - Country:US
Mailing Address - Phone:914-723-5105
Mailing Address - Fax:914-723-0634
Practice Address - Street 1:778 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5005
Practice Address - Country:US
Practice Address - Phone:914-723-5105
Practice Address - Fax:914-723-0634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003616171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty