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General NPI Number Information
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NPI Number | 1699923417
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Entity Type | Individual
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Provider Name | SHELLEY XIAOYAN PENG ACUPUNCTURIST
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Gender | Female
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 141 E 55TH ST APT 9A
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City | NEW YORK
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State | NY
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Zip | 10022-4032
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Country | US
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Telephone | 646-438-1595
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Fax |
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Provider Business Mailing Address
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Address Line | 21 CRESCENT RD
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City | GREAT NECK
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State | NY
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Zip | 11021-2701
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Country | US
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Telephone | 646-438-1595
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 000459
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License Number State | NY
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