Healthcare Provider Details

I. General information

NPI: 1083305353
Provider Name (Legal Business Name): MAIN ZOU OFFICE ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 158TH ST
FLUSHING NY
11358-3143
US

IV. Provider business mailing address

4555 158TH ST
FLUSHING NY
11358-3143
US

V. Phone/Fax

Practice location:
  • Phone: 718-799-0753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANG XIAN ZOU
Title or Position: OWNER
Credential:
Phone: 646-283-5146