Provider Demographics
NPI: | 1902103229 |
---|---|
Name: | CONSCIOUS HEALTH AND WELLNESS INC. |
Entity type: | Organization |
Organization Name: | CONSCIOUS HEALTH AND WELLNESS INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, LICENCED ACUPUNCTURIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MIRIAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PINELES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LAC |
Authorized Official - Phone: | 516-317-2539 |
Mailing Address - Street 1: | 13745 70TH RD |
Mailing Address - Street 2: | APT. 2 |
Mailing Address - City: | FLUSHING |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11367-1929 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 105 W 55TH ST |
Practice Address - Street 2: | SUITE LF |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10019-5303 |
Practice Address - Country: | US |
Practice Address - Phone: | 516-317-2539 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-02-23 |
Last Update Date: | 2011-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 4182 | 171100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171100000X | Other Service Providers | Acupuncturist | Group - Single Specialty |