MEDICARE: XU ACUPUNCTURE WELLNESS 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

General Provider Information

NPI Number	:	1720850142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XU ACUPUNCTURE WELLNESS PC

Provider Business Mailing Address
First Line	:	347 5TH AVE RM 1509
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-5049
Country	:	US
Telephone Number	:	347-659-7965
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	347 5TH AVE RM 1509
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-5049
Country	:	US
Telephone Number	:	347-659-7965
Fax Number	:	--

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	MR. DAQUAN XU
Credential	:	L.AC.
Telephone Number	:	347-659-7965

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	10/30/2023

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