Healthcare Provider Details
I. General information
NPI: 1184437402
Provider Name (Legal Business Name): DAO ACUPUNCTURE AND MASSAGE THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2619 30TH ST APT 1R
ASTORIA NY
11102-2103
US
IV. Provider business mailing address
2619 30TH ST APT 1R
ASTORIA NY
11102-2103
US
V. Phone/Fax
- Phone: 646-283-8316
- Fax:
- Phone: 646-283-8316
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUYOUNG
LEE
Title or Position: PRESIDENT
Credential: L.AC
Phone: 646-283-8316