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General NPI Number Information
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NPI Number | 1184509689
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Entity Type | Organization
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Legal Business Name | PHOENIX WELLNESS ACUPUNCTURE AND MASSAGE PC
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 4267 SAULL ST
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City | FLUSHING
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State | NY
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Zip | 11355-4917
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Country | US
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Telephone | 929-329-6790
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Fax |
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Provider Business Mailing Address
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Address Line | 4267 SAULL ST
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City | FLUSHING
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State | NY
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Zip | 11355-4917
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | XIAONA MO
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Credential | LAC
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Telephone | 929-329-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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