Healthcare Provider Details

I. General information

NPI: 1235806464
Provider Name (Legal Business Name): TI HONG ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W 46TH ST STE 505
NEW YORK NY
10036-4552
US

IV. Provider business mailing address

1386 15TH ST
FORT LEE NJ
07024-2036
US

V. Phone/Fax

Practice location:
  • Phone: 917-403-2613
  • Fax: 888-534-5993
Mailing address:
  • Phone: 917-403-2613
  • Fax: 888-534-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TI HONG
Title or Position: MANAGER
Credential:
Phone: 917-403-2613