Individual
MRS. LORI OTTAVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC. DIPL.AC.
Contact information
Practice address
72 CROFT LN, SMITHTOWN, NY 11787-4112
(516) 385-7661
(631) 979-9634
Mailing address
72 CROFT LN, SMITHTOWN, NY 11787-4112
(516) 385-7661
(631) 979-9634
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006371-1
NY
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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