Healthcare Provider Details

I. General information

NPI: 1669735122
Provider Name (Legal Business Name): TIAN NIAN HEALTH MANGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 KISSENA BLVD CONCOURSE LEVEL SUTIE# 36
FLUSHING NY
11355-3181
US

IV. Provider business mailing address

4161 KISSENA BLVD CONCOURSE LEVEL SUTIE# 36
FLUSHING NY
11355-3181
US

V. Phone/Fax

Practice location:
  • Phone: 718-358-3609
  • Fax: 718-358-3610
Mailing address:
  • Phone: 718-358-3609
  • Fax: 718-358-3610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CALVIN CHEUNG
Title or Position: MANAGING MEMBER
Credential:
Phone: 718-358-3609