Healthcare Provider Details

I. General information

NPI: 1336616424
Provider Name (Legal Business Name): WEI YU SHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2018
Last Update Date: 10/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 OCEAN AVE
EAST ROCKAWAY NY
11518-1208
US

IV. Provider business mailing address

510 OCEAN AVE
EAST ROCKAWAY NY
11518-1208
US

V. Phone/Fax

Practice location:
  • Phone: 516-399-2225
  • Fax: 516-399-2227
Mailing address:
  • Phone: 516-399-2225
  • Fax: 516-399-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004051
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: