Healthcare Provider Details

I. General information

NPI: 1639025513
Provider Name (Legal Business Name): QINGSHAN F ACUPUNCUTRE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HILLSIDE AVE STE E
WILLISTON PARK NY
11596-2308
US

IV. Provider business mailing address

5701 223RD ST FL 2
OAKLAND GARDENS NY
11364-1935
US

V. Phone/Fax

Practice location:
  • Phone: 917-518-0679
  • Fax:
Mailing address:
  • Phone: 917-518-0679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: QINGSHAN FENG
Title or Position: PRISDENT
Credential: DAOM
Phone: 917-518-0679