MEDICARE: CHANG QUEENS ACUPUNCTURE WELLNESS P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1205653441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANG QUEENS ACUPUNCTURE WELLNESS P.C.

Provider Business Mailing Address
First Line	:	3112 UNION ST APT 6B
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-2382
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7160 YELLOWSTONE BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4114
Country	:	US
Telephone Number	:	518-699-7178
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. XIU CHANG
Credential	:
Telephone Number	:	518-699-7178

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	09/19/2024

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