Kendrick A Gold, LAC.
Individual provider Active NPI Acupuncturist · Glen Head, NY
NPI 1437428638 · NPPES record last updated Dec 19, 2011
Key facts
- NPI
- 1437428638
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 004702 (NY)
- Practice address
- 5 Locust Ave
Glen Head, NY 11545-1613 - Phone
- (718) 963-2255
- NPI assigned
- Dec 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 004702 | NY | Yes |
Addresses
Primary practice location
5 Locust Ave
Glen Head, NY 11545-1613
Mailing address
5 Locust Ave
Glen Head, NY 11545-1613
Phone (718) 963-2255
Other providers in Glen Head, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.