Individual
MS. GLORIA PROVITOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L. AC.
Contact information
Practice address
448 W 57TH ST, HEALTH ON 57--GARDEN LEVEL, NEW YORK, NY 10019-3055
(917) 502-4566
Mailing address
311 W 95TH ST, APT 2B, NEW YORK, NY 10025-6103
(917) 502-4566
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004415
NY
Other
Enumeration date
03/10/2012
Last updated
03/10/2012
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