Healthcare Provider Details

I. General information

NPI: 1679375588
Provider Name (Legal Business Name): LUNA ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E 55TH ST APT 7F
NEW YORK NY
10022-4032
US

IV. Provider business mailing address

141 E 55TH ST APT 7F
NEW YORK NY
10022-4032
US

V. Phone/Fax

Practice location:
  • Phone: 646-206-1983
  • Fax:
Mailing address:
  • Phone: 646-206-1983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: QIAN REN
Title or Position: LAC
Credential:
Phone: 646-206-1983