Provider Demographics
NPI:1417106378
Name:AHLERS ACUPUNCTURE HERBAL WELLNESS, P.C.
Entity type:Organization
Organization Name:AHLERS ACUPUNCTURE HERBAL WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:AHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:631-893-3996
Mailing Address - Street 1:843 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-2726
Mailing Address - Country:US
Mailing Address - Phone:631-893-3996
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:631-893-3996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001417171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty