Individual
STEPHANIE VIDIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
180 N LONG BEACH RD, ROCKVILLE CENTRE, NY 11570-4409
(516) 868-8100
Mailing address
80 VERMONT AVE, OCEANSIDE, NY 11572-5032
(516) 425-8642
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006739
NY
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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