Healthcare Provider Details

I. General information

NPI: 1528309523
Provider Name (Legal Business Name): INTERNATIONAL ACUPUNCTURE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 ELIZABETH AVE
ELIZABETH NJ
07201-2727
US

IV. Provider business mailing address

1728 E 19TH ST UNIT B4
BROOKLYN NY
11229-2223
US

V. Phone/Fax

Practice location:
  • Phone: 347-587-5365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN WOLFSON
Title or Position: PRESIDENT
Credential:
Phone: 718-312-9527