Healthcare Provider Details

I. General information

NPI: 1487929261
Provider Name (Legal Business Name): ADVANCED ACUPUNCTURE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 REDWOOD DR
PLAINVIEW NY
11803-5215
US

IV. Provider business mailing address

14 REDWOOD DR
PLAINVIEW NY
11803-5215
US

V. Phone/Fax

Practice location:
  • Phone: 646-642-2908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SANGWON LEE
Title or Position: PRESIDENT
Credential: L.AC
Phone: 646-642-2908