Healthcare Provider Details

I. General information

NPI: 1326269457
Provider Name (Legal Business Name): YUQING YE ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 E MAIN ST
BAY SHORE NY
11706-8403
US

IV. Provider business mailing address

280 E MAIN ST PO BOX 9182
BAY SHORE NY
11706-8403
US

V. Phone/Fax

Practice location:
  • Phone: 631-758-4444
  • Fax: 631-758-1984
Mailing address:
  • Phone: 631-758-4444
  • Fax: 631-758-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number5433653
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: