Healthcare Provider Details

I. General information

NPI: 1740865187
Provider Name (Legal Business Name): LING NATURE BALANCE ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
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

5 TERRACE CIR APT 1F
GREAT NECK NY
11021-4119
US

V. Phone/Fax

Practice location:
  • Phone: 516-614-9296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: XUEMEI YANG
Title or Position: OFFICE MANAGER
Credential:
Phone: 929-426-0788