Individual
MR. ANDRE MISSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4 LANDVIEW DR, KINGS PARK, NY 11754-2827
(631) 278-0654
Mailing address
4 LANDVIEW DR, KINGS PARK, NY 11754-2827
(631) 278-0654
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004784
NY
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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