MEDICARE: EARTH MOUNTAIN ACUPUNCTURE,P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1053202457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARTH MOUNTAIN ACUPUNCTURE,P.C.

Provider Business Mailing Address
First Line	:	3366 PARK AVE STE 210
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-3718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3366 PARK AVE STE 210
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-3718
Country	:	US
Telephone Number	:	516-879-2809
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YANNI KANG
Credential	:
Telephone Number	:	516-879-2806

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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Directions to “EARTH MOUNTAIN ACUPUNCTURE,P.C. ” Practice Location

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