Healthcare Provider Details

I. General information

NPI: 1861828634
Provider Name (Legal Business Name): TUO NA LIANG L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13124 ROCKAWAY BLVD
SOUTH OZONE PARK NY
11420-2932
US

IV. Provider business mailing address

13124 ROCKAWAY BLVD
SOUTH OZONE PARK NY
11420-2932
US

V. Phone/Fax

Practice location:
  • Phone: 917-346-3754
  • Fax:
Mailing address:
  • Phone: 917-346-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004280
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: