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General NPI Number Information
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NPI Number | 1871356006
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Entity Type | Organization
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Legal Business Name | SERENE ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 8106 BAXTER AVE STE MC2
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City | ELMHURST
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State | NY
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Zip | 11373-1389
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Country | US
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Telephone | 718-639-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 154 PHELPS AVE
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City | CRESSKILL
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State | NJ
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Zip | 07626-2426
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Country | US
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Telephone | 201-966-7828
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | PAUL MINSEOK TAK
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Credential | L.AC
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Telephone | 201-966-7828
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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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