Healthcare Provider Details

I. General information

NPI: 1205172434
Provider Name (Legal Business Name): PING ZHU ACUPUNCTURE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2012
Last Update Date: 12/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N BROADWAY STE 106
HICKSVILLE NY
11801-2929
US

IV. Provider business mailing address

69 MEADOWBROOK RD
SYOSSET NY
11791-2117
US

V. Phone/Fax

Practice location:
  • Phone: 516-827-0887
  • Fax: 516-827-0887
Mailing address:
  • Phone: 516-827-0887
  • Fax: 516-827-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number000441
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: