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General NPI Number Information
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NPI Number | 1366911067
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Entity Type | Individual
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Provider Name | XING JUN HUANGPU L.AC., LMT
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Gender | Male
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 13621 ROOSEVELT AVE STE 304
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City | FLUSHING
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State | NY
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Zip | 11354-5507
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Country | US
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Telephone | 929-855-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 13621 ROOSEVELT AVE STE 304
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City | FLUSHING
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State | NY
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Zip | 11354-5507
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Country | US
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Telephone | 929-855-0028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 031402
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License Number State | NY
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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 | 006982
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License Number State | NY
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