Healthcare Provider Details

I. General information

NPI: 1083017966
Provider Name (Legal Business Name): YUPO WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 CANAL ST LOWER LEVEL A
NEW YORK NY
10013-1691
US

IV. Provider business mailing address

393 CANAL ST LOWER LEVEL A
NEW YORK NY
10013-1691
US

V. Phone/Fax

Practice location:
  • Phone: 212-343-7955
  • Fax:
Mailing address:
  • Phone: 212-343-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004925
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034946
License Number StateNY

VIII. Authorized Official

Name: CHING PO HUANG
Title or Position: PRESIDENT
Credential: L.AC
Phone: 212-343-7955