Healthcare Provider Details

I. General information

NPI: 1407459597
Provider Name (Legal Business Name): WEST EAST INDEPENDENT PRACTICE ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14238 37TH AVE STE 1D
FLUSHING NY
11354-4580
US

IV. Provider business mailing address

14238 37TH AVE STE 1D
FLUSHING NY
11354-4580
US

V. Phone/Fax

Practice location:
  • Phone: 718-313-8585
  • Fax: 718-228-9172
Mailing address:
  • Phone: 718-313-8585
  • Fax: 718-228-9172

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: GUIXIANG YUE
Title or Position: PRESIDENT
Credential: L.AC
Phone: 718-313-8585