Healthcare Provider Details

I. General information

NPI: 1356487649
Provider Name (Legal Business Name): HANLONG YAO LIC. ACUPUNCTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6216 MONTROSE RD
ROCKVILLE MD
20852-4119
US

IV. Provider business mailing address

6216 MONTROSE RD
ROCKVILLE MD
20852-4119
US

V. Phone/Fax

Practice location:
  • Phone: 301-230-9155
  • Fax: 301-881-8737
Mailing address:
  • Phone: 301-230-9155
  • Fax: 301-881-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU00355
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: