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General NPI Number Information
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NPI Number | 1265608814
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Entity Type | Organization
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Legal Business Name | ULTIMATE HEALING & ACUPUNCTURE PC
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Dates
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Enumeration Date | 05/04/2008
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Last Update Date | 05/04/2008
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Provider Practice Location Address
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Address Line | 230 MIDDLE NECK RD SUITE 1
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City | GREAT NECK
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State | NY
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Zip | 11021-1113
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Country | US
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Telephone | 917-376-6886
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Fax | 212-688-8283
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Provider Business Mailing Address
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Address Line | 401 E 58TH ST SUITE C6
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City | NEW YORK
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State | NY
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Zip | 10022-2312
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Country | US
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Telephone | 917-376-6886
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST/OWNER
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Name | MS. XIAO L XU
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Credential | LAC
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Telephone | 917-376-6886
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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 | 002844
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License Number State | NY
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