Individual
MRS. JACQUELINE FAZZALARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
3749 91ST ST, 2ND FLOOR, JACKSON HEIGHTS, NY 11372-7927
(718) 775-8990
Mailing address
5285 72ND PL, APT 2, MASPETH, NY 11378-1515
(917) 608-2098
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005209
NY
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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