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Individual

DIANE FAY CARRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACUPUNCTURIST

Contact information

Practice address
288 MAIN ST, MIDDLEBURGH, NY 12122-6519
(518) 810-5224
Mailing address
288 MAIN ST STE 5, MIDDLEBURGH, NY 12122-6519
(518) 810-5224

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007223
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
843850215
NY
Enumeration date
12/26/2022
Last updated
12/26/2022
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