Provider Demographics
NPI:1669894812
Name:AG ACUPUNCTURE P.C.
Entity type:Organization
Organization Name:AG ACUPUNCTURE P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DIPL OM
Authorized Official - Phone:914-572-5057
Mailing Address - Street 1:2400 JOHNSON AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6466
Mailing Address - Country:US
Mailing Address - Phone:914-572-5057
Mailing Address - Fax:
Practice Address - Street 1:3333 HENRY HUDSON PKWY APT 1A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3235
Practice Address - Country:US
Practice Address - Phone:914-572-5057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4857171100000X
CA004857171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty