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General NPI Number Information
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NPI Number | 1225151350
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE ACUPUNCTURE, P.C.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 32 UNION SQ E ROOM 804
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City | NEW YORK
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State | NY
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Zip | 10003-3209
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Country | US
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Telephone | 212-533-1192
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 W 5TH ST APT 21H
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City | BROOKLYN
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State | NY
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Zip | 11224-3965
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Country | US
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Telephone | 212-533-1192
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. MARK MOSHCHINSKY
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Credential | L.AC. (NCCAOM)
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Telephone | 212-533-1192
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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 | 000445
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License Number State | NY
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