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NPI Code Detail

MEDICARE: DR. QIFANG REN LAC

MEDICARE: DR. QIFANG REN LAC
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
1171100000XAcupuncturist001675NY

General Provider Information

NPI Number : 1962577874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QIFANG REN LAC
Provider Business Mailing Address
First Line : 189 MONTAGUE ST
Second Line : SUITE 302
City : BROOKLYN
State : NY
Zip : 11201-3610
Country : US
Telephone Number : 718-403-9000
Fax Number : 718-403-0166
Provider Business Practice Location Address
First Line : 189 MONTAGUE ST
Second Line : SUITE 302
City : BROOKLYN
State : NY
Zip : 11201-3610
Country : US
Telephone Number : 718-403-9000
Fax Number : 718-403-0166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 07/08/2007

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Directions to “ DR. QIFANG REN LAC” Practice Location

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