Individual
JEFFREY ROSS VANDYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L AC
Contact information
Practice address
433 W 21ST ST APT 4C, NEW YORK, NY 10011-2909
(212) 627-0968
Mailing address
433 W 21ST ST APT 4C, NEW YORK, NY 10011-2909
(212) 627-0968
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
941-1
NY
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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