Basic Information
| Provider Information | |||||||||
| NPI: | 1811146442 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OS HARMONY ACUPUNCTURE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 221 AVENUE V | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112234618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189136780 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 MIDLAND AVE | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103062427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186677778 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2008 | ||||||||
| LastUpdateDate: | 09/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | SHARGORODSKIY | ||||||||
| AuthorizedOfficialFirstName: | OLEG | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7189136780 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | L.AC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | 003067 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.