Provider Demographics
NPI:1285286856
Name:NEUROLOQI ACUPUNCTURE
Entity type:Organization
Organization Name:NEUROLOQI ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAC LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:585-542-9239
Mailing Address - Street 1:600 PARK AVE
Mailing Address - Street 2:CARRIAGE HOUSE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607
Mailing Address - Country:US
Mailing Address - Phone:585-542-9239
Mailing Address - Fax:
Practice Address - Street 1:600 PARK AVE
Practice Address - Street 2:CARRIAGE HOUSE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607
Practice Address - Country:US
Practice Address - Phone:585-542-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1609143353OtherNPI # FOR DESIREE SALE
NY1659834398OtherNPI # FOR KAYLA WOODS