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General NPI Number Information
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NPI Number | 1306318431
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Entity Type | Organization
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Legal Business Name | COMMACK ACUPUNCTURE PC
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Dates
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Enumeration Date | 12/31/2018
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Last Update Date | 12/31/2018
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Provider Practice Location Address
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Address Line | 164 COMMACK RD STE 1
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City | COMMACK
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State | NY
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Zip | 11725-3430
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Country | US
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Telephone | 631-858-0325
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Fax |
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Provider Business Mailing Address
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Address Line | 553 OLD COUNTRY RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-4923
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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 | MANAGER
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Name | MING YANG
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Credential |
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Telephone | 917-678-6541
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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 |
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License Number State |
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