Healthcare Provider Details

I. General information

NPI: 1164277091
Provider Name (Legal Business Name): ZEST ACUPUNCTURE @ PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 JOHN ST STE 520
NEW YORK NY
10038-3141
US

IV. Provider business mailing address

111 JOHN ST STE 520
NEW YORK NY
10038-3141
US

V. Phone/Fax

Practice location:
  • Phone: 347-395-1623
  • Fax:
Mailing address:
  • Phone: 347-395-1623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HONGLAN TAO
Title or Position: OWNER
Credential:
Phone: 347-395-1623