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General NPI Number Information
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NPI Number | 1821840240
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ACUPUNCTURE WELLNESS PLLC
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 586 WARBURTON AVE
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-1504
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Country | US
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Telephone | 929-266-7892
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Fax |
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Provider Business Mailing Address
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Address Line | 7328 199TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11366-1823
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Country | US
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Telephone | 929-266-7892
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BOJU WANG
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Credential |
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Telephone | 929-266-7892
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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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