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General NPI Number Information
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NPI Number | 1639504483
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Entity Type | Organization
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Legal Business Name | MANNA ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 22 CHERRYWOOD RD
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City | YONKERS
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State | NY
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Zip | 10710-1102
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Country | US
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Telephone | 914-419-2223
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Fax | 914-337-5533
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Provider Business Mailing Address
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Address Line | 22 CHERRYWOOD RD
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City | YONKERS
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State | NY
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Zip | 10710-1102
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Country | US
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Telephone | 914-419-2223
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Fax | 914-337-5533
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MANNA LU-WONG
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Credential | RN, L.AC, RMT
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Telephone | 914-419-2223
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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 | 004087
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License Number State | NY
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