Provider Demographics
NPI:1881323723
Name:DEACETIS, ANGELA SUN (LAC, DACM, MSTOM)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:SUN
Last Name:DEACETIS
Suffix:
Gender:F
Credentials:LAC, DACM, MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BAISLEY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1815
Mailing Address - Country:US
Mailing Address - Phone:516-880-3609
Mailing Address - Fax:
Practice Address - Street 1:42 BAISLEY AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1815
Practice Address - Country:US
Practice Address - Phone:718-288-3288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007043-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist