Healthcare Provider Details

I. General information

NPI: 1245408244
Provider Name (Legal Business Name): YUXIA QIU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA YUXIA QIU

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 BROADWAY #509
NEW YORK NY
10023-7603
US

IV. Provider business mailing address

1841 BROADWAY #509
NEW YORK NY
10023-7603
US

V. Phone/Fax

Practice location:
  • Phone: 646-240-1023
  • Fax:
Mailing address:
  • Phone: 646-240-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00568
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: