Individual
PATTI KIBATULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LA.C, MSAC
Contact information
Practice address
572 GRAND ST APT G902, NEW YORK, NY 10002-2987
(646) 345-7378
Mailing address
572 GRAND ST APT 902, NEW YORK, NY 10002-2987
(646) 345-7378
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005760
NY
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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