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General NPI Number Information
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NPI Number | 1366059255
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Entity Type | Organization
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Legal Business Name | SHINE ACUPUNCTURE WELLNESS PLLC
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 128 FORT WASHINGTON AVE APT J
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City | NEW YORK
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State | NY
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Zip | 10032-4735
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Country | US
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Telephone | 212-568-5100
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Fax | 212-568-5105
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Provider Business Mailing Address
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Address Line | 128 FORT WASHINGTON AVE APT J
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City | NEW YORK
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State | NY
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Zip | 10032-4735
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Country | US
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Telephone | 212-568-5100
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Fax | 212-568-5105
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Authorized Official
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Title or Position | LAC, OM / CHIEF OFFICER
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Name | MEEI MIAW LIN
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Credential | LAC .DAOM
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Telephone | 914-819-2713
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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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