Provider Demographics
NPI:1447666284
Name:OLA KALA HEALING ARTS CORP
Entity type:Organization
Organization Name:OLA KALA HEALING ARTS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JERI
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:GARGANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:631-220-3193
Mailing Address - Street 1:343 S DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5151
Mailing Address - Country:US
Mailing Address - Phone:631-220-3193
Mailing Address - Fax:631-225-0304
Practice Address - Street 1:343 S DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5151
Practice Address - Country:US
Practice Address - Phone:631-220-3193
Practice Address - Fax:631-225-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004732171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty