Healthcare Provider Details

I. General information

NPI: 1184225765
Provider Name (Legal Business Name): WU-WEI ACUPUNCTURE & HERBS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56A MOTOR AVE
SOUTH FARMINGDALE NY
11735-4038
US

IV. Provider business mailing address

740 E BROADWAY APT 1G
LONG BEACH NY
11561-4702
US

V. Phone/Fax

Practice location:
  • Phone: 516-752-1910
  • Fax:
Mailing address:
  • Phone: 914-646-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JUSTIN MANDEL
Title or Position: OWNER
Credential: LAC
Phone: 914-646-4545