MEDICARE: VALLEY ACUPUNCTURE CARE PC

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	4164	NY
2	171100000X	Acupuncturist	4817	NY

General Provider Information

NPI Number	:	1215486824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY ACUPUNCTURE CARE PC

Provider Business Mailing Address
First Line	:	3447 77TH STREET
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3447 77TH STREET
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372
Country	:	US
Telephone Number	:	718-406-9588
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. XIAOHONG ZHAO
Credential	:
Telephone Number	:	718-406-9588

Provider Enumeration Date	:	09/23/2016
Last Update Date	:	09/23/2016

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