Provider Demographics
NPI:1538642764
Name:ACUPUNCTURERX
Entity type:Organization
Organization Name:ACUPUNCTURERX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRABAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, LAC
Authorized Official - Phone:570-630-4001
Mailing Address - Street 1:410 1/2 REAR FRONT ST
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:PA
Mailing Address - Zip Code:18434-1946
Mailing Address - Country:US
Mailing Address - Phone:215-435-1109
Mailing Address - Fax:
Practice Address - Street 1:73 MONTAGE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1751
Practice Address - Country:US
Practice Address - Phone:570-876-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center