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General NPI Number Information
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NPI Number | 1013362425
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Entity Type | Organization
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Legal Business Name | RUYI ACUPUNCTURE, PC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 85 S BROADWAY
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City | HICKSVILLE
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State | NY
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Zip | 11801-4387
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Country | US
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Telephone | 516-610-0107
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Fax |
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Provider Business Mailing Address
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Address Line | 85 S BROADWAY
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City | HICKSVILLE
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State | NY
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Zip | 11801-4387
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Country | US
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Telephone | 516-610-0107
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT WULFORST
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Credential | L.AC, AP
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Telephone | 516-610-0107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 002740
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License Number State | NY
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