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General NPI Number Information
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NPI Number | 1780011650
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Entity Type | Organization
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Legal Business Name | NEO CARE ACUPUNCTURE P.C.
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 18507 64TH AVE
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-2707
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Country | US
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Telephone | 718-445-7121
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Fax |
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Provider Business Mailing Address
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Address Line | 19505A 67TH AVE APT 3C
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3922
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Country | US
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Telephone | 201-274-6577
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN YANG
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Credential | L.AC.
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Telephone | 201-274-6577
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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 | 002498
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License Number State | NY
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