Healthcare Provider Details

I. General information

NPI: 1649108713
Provider Name (Legal Business Name): ADVANCED ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LITTLE NEW YORK RD
RISING SUN MD
21911-1932
US

IV. Provider business mailing address

125 LITTLE NEW YORK RD
RISING SUN MD
21911-1932
US

V. Phone/Fax

Practice location:
  • Phone: 410-900-2227
  • Fax: 240-540-6166
Mailing address:
  • Phone: 410-900-2227
  • Fax: 240-540-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: IANA IBRAHIM
Title or Position: OWNER
Credential: B.SC , M.AC, L.AC
Phone: 410-900-2227