Healthcare Provider Details
I. General information
NPI: 1427961754
Provider Name (Legal Business Name): LOTUS VALLEY ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2098 ROCKAWAY PKWY
BROOKLYN NY
11236-5802
US
IV. Provider business mailing address
2098 ROCKAWAY PKWY
BROOKLYN NY
11236-5802
US
V. Phone/Fax
- Phone: 718-484-9393
- Fax:
- Phone:
- 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: MR.
PAWEL
GIERUCKI
Title or Position: OWNER
Credential: L.AC
Phone: 718-753-3788