Provider Demographics
NPI:1104312529
Name:DEL SOL, MADELINE SARA (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:SARA
Last Name:DEL SOL
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 1:300 ANDREWS WAY APT 207
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-6997
Mailing Address - Country:US
Mailing Address - Phone:786-223-4579
Mailing Address - Fax:
Practice Address - Street 1:173 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2141
Practice Address - Country:US
Practice Address - Phone:860-503-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT732171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist