Healthcare Provider Details

I. General information

NPI: 1053986653
Provider Name (Legal Business Name): PROFOUND POINTS ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8784 165TH ST APT 105
JAMAICA NY
11432-3542
US

IV. Provider business mailing address

8784 165TH ST APT 105
JAMAICA NY
11432-3542
US

V. Phone/Fax

Practice location:
  • Phone: 917-676-8265
  • Fax:
Mailing address:
  • Phone: 917-676-8265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTOR ESCORBORES II
Title or Position: PRESIDENT
Credential: DAC
Phone: 917-676-8265