Healthcare Provider Details

I. General information

NPI: 1114485869
Provider Name (Legal Business Name): YUNG HWA ASIAN HEALING ARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5718 WOODSIDE AVE STE B102
WOODSIDE NY
11377-3444
US

IV. Provider business mailing address

6044 83RD ST
MIDDLE VILLAGE NY
11379-5444
US

V. Phone/Fax

Practice location:
  • Phone: 718-426-7900
  • 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 Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: VERA YUNG
Title or Position: MANAGING MEMBER
Credential: LAC
Phone: 917-541-7897