Individual
LEI LEI PEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7328 199TH ST, FRESH MEADOWS, NY 11366-1823
(646) 581-1886
Mailing address
7328 199TH ST, FRESH MEADOWS, NY 11366-1823
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007296-01
NY
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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