Healthcare Provider Details
I. General information
NPI: 1003603994
Provider Name (Legal Business Name): HLA NY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 GLEN COVE RD
CARLE PLACE NY
11514
US
IV. Provider business mailing address
PO BOX 222169
GREAT NECK NY
11022-2169
US
V. Phone/Fax
- Phone: 347-825-8532
- 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:
HUI-LI
TSO
Title or Position: ACUPUNCTURIST
Credential:
Phone: 646-824-0580