Healthcare Provider Details

I. General information

NPI: 1982218129
Provider Name (Legal Business Name): CHINESE MEDICINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TERRY DR STE 18
NEWTOWN PA
18940-1838
US

IV. Provider business mailing address

4 TERRY DR STE 18
NEWTOWN PA
18940-1838
US

V. Phone/Fax

Practice location:
  • Phone: 215-488-7896
  • Fax:
Mailing address:
  • Phone: 215-488-7896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. XIN YAO WANG
Title or Position: ACUPUNCTURIST
Credential:
Phone: 215-262-7983