Healthcare Provider Details

I. General information

NPI: 1003212036
Provider Name (Legal Business Name): 133 ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MADISON AVE ROOM 510
NEW YORK NY
10017-5405
US

IV. Provider business mailing address

315 MADISON AVE ROOM 510
NEW YORK NY
10017-5405
US

V. Phone/Fax

Practice location:
  • Phone: 212-888-6788
  • Fax:
Mailing address:
  • Phone: 212-888-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004806
License Number StateNY

VIII. Authorized Official

Name: RICHARD HSU
Title or Position: COO
Credential:
Phone: 212-888-6788