MEDICARE: GOTHAM INTEGRATIVE ACUPUNCTURE AND WELLNESS PLLC

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	:	1972071223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOTHAM INTEGRATIVE ACUPUNCTURE AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	39 W 14TH ST STE 502
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7403
Country	:	US
Telephone Number	:	646-255-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 W 14TH ST. SUITE 502
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7403
Country	:	US
Telephone Number	:	646-255-1332
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PRACTITIONER
Name	:	MS. KRISTIN D CHENG
Credential	:	L.AC., LMT
Telephone Number	:	646-255-1332

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	05/07/2026

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