Individual
PAUL J FUCCILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC. LMT MS MA
Contact information
Practice address
28 BIRCHWOOD DR, HUNTINGTON STATION, NY 11746-3902
(631) 223-3385
Mailing address
28 BIRCHWOOD DR, HUNTINGTON STATION, NY 11746-3902
(631) 223-3385
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004701
NY
225700000X
Massage Therapist
024021
NY
Other
Enumeration date
06/17/2013
Last updated
06/18/2013
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