Provider Demographics
NPI:1952735771
Name:OASIS OF ACUPUNCTURE, PC
Entity Type:Organization
Organization Name:OASIS OF ACUPUNCTURE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:631-588-1700
Mailing Address - Street 1:879 JOHNSON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6081
Mailing Address - Country:US
Mailing Address - Phone:631-588-1700
Mailing Address - Fax:631-588-1705
Practice Address - Street 1:879 JOHNSON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6081
Practice Address - Country:US
Practice Address - Phone:631-588-1700
Practice Address - Fax:631-588-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty