Individual
LEI HE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17-19 WEST 45 STREET SUITE505, NEW YORK, NY 10036-1003
(917) 675-6571
(917) 675-6571
Mailing address
17-19 W 45TH ST STE505, NEW YORK, NY 10036-1104
(646) 409-9227
(917) 675-6571
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005652
NY
Other
Enumeration date
12/23/2015
Last updated
09/16/2019
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