Healthcare Provider Details

I. General information

NPI: 1114375813
Provider Name (Legal Business Name): YAN'S ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HONEYCOMB LN
NORTH HAVEN CT
06473-1005
US

IV. Provider business mailing address

5 HONEYCOMB LANE
NORTH HAVEN CT
06473
US

V. Phone/Fax

Practice location:
  • Phone: 203-903-0471
  • Fax:
Mailing address:
  • Phone: 203-903-0471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number000569
License Number StateCT

VIII. Authorized Official

Name: DR. YAN HUO
Title or Position: ACUPUNCTURIST
Credential: OMD, PHD.,LAC.
Phone: 203-903-0471