Healthcare Provider Details

I. General information

NPI: 1063933133
Provider Name (Legal Business Name): QIANQIU LOTUS HUANG L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOTUS HUANG L.AC

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 LEXINGTON AVE RM 1205
NEW YORK NY
10016-0942
US

IV. Provider business mailing address

353 LEXINGTON AVE RM 1205
NEW YORK NY
10016-0942
US

V. Phone/Fax

Practice location:
  • Phone: 347-282-2978
  • Fax: 888-928-1126
Mailing address:
  • Phone: 347-282-2978
  • Fax: 888-928-1126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006001-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number006001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: