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General NPI Number Information
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NPI Number | 1700429305
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Entity Type | Organization
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Legal Business Name | RISING LOTUS ACUPUNCTURE
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 10/26/2019
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Provider Practice Location Address
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Address Line | 7216 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6335
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Country | US
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Telephone | 347-808-8033
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Fax |
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Provider Business Mailing Address
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Address Line | 7216 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6335
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Country | US
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Telephone | 347-808-8033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WAI FUNG NGAN
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Credential | L.AC
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Telephone | 646-925-8884
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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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