Medzdabe Desravines, LAC, MSTOM, DIPL

NPI #1770131849 in Mineola, New York

Provider Information

NPI Number: 1770131849
Entity Type: Individual
Name: Medzdabe Desravines, LAC, MSTOM, DIPL
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Acupuncturist
Credential: LAC, MSTOM, DIPL
Enumeration Date: Aug 30, 2019
Last Updated: Jul 10, 2024

Practice Location

Address: 200 OLD COUNTRY RD STE 140
City: Mineola
State: New York
ZIP Code: 11501-4273
Phone: (516) 794-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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