Individual
JASON MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
220 INDIAN HEAD RD, KINGS PARK, NY 11754-4802
(631) 912-7035
Mailing address
220 INDIAN HEAD RD, KINGS PARK, NY 11754-4802
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007277-01
NY
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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