Healthcare Provider Details

I. General information

NPI: 1518390699
Provider Name (Legal Business Name): MS. QIAN ZUO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

241 W 37TH ST SUITE 405
NEW YORK NY
10018-5705
US

IV. Provider business mailing address

21941 67TH AVE 2F
BAYSIDE NY
11364-2638
US

V. Phone/Fax

Practice location:
  • Phone: 347-886-7208
  • Fax:
Mailing address:
  • Phone: 347-886-7208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005090
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: