Organization
VISHVA VAJRA ACUPUNCTURE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XU GAO LAC (ACUPUNCTIST)
(917) 362-3868
Entity
Organization
Contact information
Practice address
23A MIDDLE NECK ROAD, GREAT NECK, NY 11021
(917) 362-3868
Mailing address
23 RINI RD, GLEN HEAD, NY 11545-2410
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004826
NY
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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