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General NPI Number Information
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NPI Number | 1467540948
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Entity Type | Organization
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Legal Business Name | SOUTH QUEENS ACUPUCTURE, P.C.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13122 ROCKAWAY BLVD
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420
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Country | US
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Telephone | 718-659-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 13122 ROCKAWAY BLVD
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420
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Country | US
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Telephone | 718-659-7166
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAMIL M ABRAHAM
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Credential | M.D.
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Telephone | 718-659-7166
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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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