MEDICARE: PRISCILLA S KANG 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	U02307	MD

General Provider Information

NPI Number	:	1992483945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA S KANG L.AC

Provider Business Mailing Address
First Line	:	4334 196TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-3521
Country	:	US
Telephone Number	:	347-255-4943
Fax Number	:

Provider Business Practice Location Address
First Line	:	4334 196TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-3521
Country	:	US
Telephone Number	:	347-255-4943
Fax Number	:

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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Directions to “ PRISCILLA S KANG L.AC” Practice Location

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