Individual
SIMONE WAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC, M.S.T.O.M.
Contact information
Practice address
251 5TH AVE, 3RD FLOOR, NEW YORK, NY 10016-6515
(646) 221-5057
Mailing address
163 EDGE HILL RD, FAIRFIELD, CT 06824-5213
(646) 221-5057
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
002972
NY
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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