Healthcare Provider Details

I. General information

NPI: 1265869564
Provider Name (Legal Business Name): HUILI TSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WELWYN RD # 2169
GREAT NECK NY
11022-5042
US

IV. Provider business mailing address

1 WELWYN RD # 2169
GREAT NECK NY
11022-5042
US

V. Phone/Fax

Practice location:
  • Phone: 516-487-4317
  • Fax:
Mailing address:
  • Phone: 516-487-4317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005154-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: