Provider Demographics
NPI:1104133677
Name:ARMSTRONG, NICOLE (ACUPUNCTURIST)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BUENA VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6561
Mailing Address - Country:US
Mailing Address - Phone:516-582-7355
Mailing Address - Fax:
Practice Address - Street 1:79 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2839
Practice Address - Country:US
Practice Address - Phone:631-587-4629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003734171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist