Healthcare Provider Details

I. General information

NPI: 1346171212
Provider Name (Legal Business Name): FIFTH ELEMENT ACUPUNCTURE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BROADWAY STE 908
NEW YORK NY
10006-2574
US

IV. Provider business mailing address

8036 217TH ST
QUEENS VILLAGE NY
11427-1106
US

V. Phone/Fax

Practice location:
  • Phone: 212-379-6413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ORNA ISKHAKOV
Title or Position: OWNER / OPERATPR
Credential: LAC
Phone: 347-596-0931