Provider Demographics
NPI:1154880367
Name:DEL VECCHIO, BRIANNA MARIE (LMT, LAC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:DEL VECCHIO
Suffix:
Gender:F
Credentials:LMT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E HOFFMAN AVE UNIT 508
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-8021
Mailing Address - Country:US
Mailing Address - Phone:631-464-6408
Mailing Address - Fax:
Practice Address - Street 1:459 S WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-4936
Practice Address - Country:US
Practice Address - Phone:631-464-6408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031573225700000X
NY007349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY262601119OtherAMITYVILLE ACUPUNCTURE AND MASSAGE PLLC