Healthcare Provider Details

I. General information

NPI: 1992113658
Provider Name (Legal Business Name): HEALTH WISH ACUPUNCTURE AND MASSAGE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PROSPECT STREET SUITE 109
HUNTINGTON NY
11743
US

IV. Provider business mailing address

26 WEDGEWOOD DRIVE
WESTBURY NY
11590
US

V. Phone/Fax

Practice location:
  • Phone: 516-279-0918
  • Fax:
Mailing address:
  • Phone: 516-279-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005262-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number026675-1
License Number StateNY

VIII. Authorized Official

Name: MEHWISH CHUGHTAI
Title or Position: OWNER
Credential: LAC, LMT
Phone: 516-279-0918