Modern Traditions Wellness

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

MODERN TRADITIONS WELLNESS

Practice address

333 Glen Head Rd Ste 155
Glen Head, NY 11545-1945

Phone

(516) 200-5249

NPI assigned

Dec 11, 2024

Last updated

Dec 11, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daniel Elliott Whitely, LACNPI 1831961606

Title

Owner

Phone

(516) 200-5249

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Elliott Whitely, DIPL.

  • Acupuncturist
  • Glen Head, NY
  • NPI 1831961606
  NPD Authorized official
• Krystalanne Marie Zivkovich, LAC

  • Acupuncturist
  • Glen Head, NY
  • NPI 1225843675
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1689481947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD STE 155",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451945",
            "telephone_number": "516-200-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD STE 155",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451945",
            "telephone_number": "516-200-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN TRADITIONS WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "WHITELY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-200-5249",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry M Mensch, D.D.S.,P.C.
• Helene Dale Mermelstein, PSY.D
• Michael B Capobianco MD
• Lauren Shady Mizrahi
• Mojgan Mizrahi, RDN CDN
• Cheryl Moeller, ANP-C
• Lisa Mollick, LMHC
• Nicole E Muia
• Mackenzie Ryan Mulholland
• Eileen Murphy, OTR/L

• Acupuncturist in Glen Head, NY
• Providers in Glen Head, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.