Healthcare Provider Details

I. General information

NPI: 1366231714
Provider Name (Legal Business Name): HUAN PAN ACUPUNCTURE P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23927 65TH AVE
LITTLE NECK NY
11362-1918
US

IV. Provider business mailing address

23927 65TH AVE
LITTLE NECK NY
11362-1918
US

V. Phone/Fax

Practice location:
  • Phone: 718-808-5099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HUAN PAN
Title or Position: PRESIDENT
Credential:
Phone: 718-808-5099