# ANCIENT & MODERN ACUPUNCTURE P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730582032
- **Authorized official:** YEVGENIY VOLOSHCHUK LAC (ACUPUNCTURIST)
- **Authorized official phone:** (917) 658-0152

## Contact information

- **Practice address:** 4131 RICHMOND AVE, STATEN ISLAND, NY 10312-5633
- **Practice address phone:** (718) 984-0024
- **Practice address fax:** (718) 984-4036
- **Mailing address:** 75 SMITH ST, PERTH AMBOY, NJ 08861-4413
- **Mailing address phone:** (732) 442-5542
- **Mailing address fax:** (732) 442-5568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 002065 | NY | Yes |

## Other

- **Enumeration date:** 09/30/2014
- **Last updated:** 05/25/2016