Provider Demographics
NPI:1912433186
Name:PAIN MANAGEMENT ACUPUNCTURE
Entity Type:Organization
Organization Name:PAIN MANAGEMENT ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:ZEMCOV
Authorized Official - Suffix:
Authorized Official - Credentials:MSAOM,LAC
Authorized Official - Phone:585-267-7346
Mailing Address - Street 1:135 SULLYS TRL STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4564
Mailing Address - Country:US
Mailing Address - Phone:585-267-7346
Mailing Address - Fax:
Practice Address - Street 1:135 SULLYS TRL STE 3
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4564
Practice Address - Country:US
Practice Address - Phone:585-267-7346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005927-1261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain