Healthcare Provider Details

I. General information

NPI: 1861584237
Provider Name (Legal Business Name): SIPING WU L. AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 W HENRIETTA RD STE 5B
ROCHESTER NY
14623-1360
US

IV. Provider business mailing address

2024 W HENRIETTA RD STE 5B
ROCHESTER NY
14623-1360
US

V. Phone/Fax

Practice location:
  • Phone: 585-272-7340
  • Fax: 585-272-0562
Mailing address:
  • Phone: 585-272-7340
  • Fax: 585-272-0562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0001099
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: