Healthcare Provider Details

I. General information

NPI: 1265233399
Provider Name (Legal Business Name): KANGLI ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NORTHERN BLVD
GREAT NECK NY
11021-4301
US

IV. Provider business mailing address

843 60TH ST APT A6
BROOKLYN NY
11220-4331
US

V. Phone/Fax

Practice location:
  • Phone: 917-443-9551
  • Fax:
Mailing address:
  • Phone: 917-443-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS KANGLI ZHENG I
Title or Position: OWNER
Credential:
Phone: 917-443-9551