Healthcare Provider Details

I. General information

NPI: 1215621487
Provider Name (Legal Business Name): XIAO HUANG ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430-09 NORTH COUNTRY RD
SAINT JAMES NY
11780-1759
US

IV. Provider business mailing address

66 HILLARY LN
WESTBURY NY
11590
US

V. Phone/Fax

Practice location:
  • Phone: 347-931-8855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: XIAO HUANG
Title or Position: OWNER
Credential:
Phone: 347-931-8855