MEDICARE: SHUANG HUO L.AC

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	003104	NY

General Provider Information

NPI Number	:	1245405257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUANG HUO L.AC

Provider Business Mailing Address
First Line	:	80 CENTRAL PARK W STE B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-5204
Country	:	US
Telephone Number	:	646-365-3412
Fax Number	:	646-367-3498

Provider Business Practice Location Address
First Line	:	80 CENTRAL PARK W STE B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-5204
Country	:	US
Telephone Number	:	646-365-3412
Fax Number	:	646-367-3498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	04/30/2008

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Directions to “ SHUANG HUO L.AC” Practice Location

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