Provider Demographics
NPI:1457140121
Name:ACUPUNCTURE LOCAL PC
Entity type:Organization
Organization Name:ACUPUNCTURE LOCAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-657-4386
Mailing Address - Street 1:675 W 187TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1328
Mailing Address - Country:US
Mailing Address - Phone:347-657-4386
Mailing Address - Fax:
Practice Address - Street 1:4386 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4002
Practice Address - Country:US
Practice Address - Phone:347-657-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1407397151OtherBLUE CROSS BLUE SHIELD AND NORTHWELL