Organization
BLVD SKIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY DE COSTA BYER L.AC. (ACUPUNCTURIST)
(917) 943-3682
Entity
Organization
Contact information
Practice address
8635 QUEENS BLVD, 1-A, ELMHURST, NY 11373-4434
(917) 943-3682
Mailing address
8635 QUEENS BLVD, 1-A, ELMHURST, NY 11373-4434
(917) 943-3682
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004720
NY
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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