Healthcare Provider Details
I. General information
NPI: 1992408199
Provider Name (Legal Business Name): CHONG ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2023
Last Update Date: 04/26/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
99 JERICHO TPKE STE 304
JERICHO NY
11753-1015
US
IV. Provider business mailing address
155 WESTWOOD DR APT 172
WESTBURY NY
11590-1627
US
V. Phone/Fax
- Phone: 516-888-0868
- Fax: 516-363-4566
- Phone: 347-506-5816
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHONG
ZHAO
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 347-506-5816