MEDICARE: WAN MEI WOO L.AC

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	0199	NY

General Provider Information

NPI Number	:	1366095317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAN MEI WOO L.AC

Provider Business Mailing Address
First Line	:	4151 77TH ST STE 1F
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1935
Country	:	US
Telephone Number	:	718-458-6391
Fax Number	:	646-365-3210

Provider Business Practice Location Address
First Line	:	4151 77TH ST STE 1F
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1935
Country	:	US
Telephone Number	:	718-458-6391
Fax Number	:	646-365-3210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2019
Last Update Date	:	07/18/2019

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1952433468 — WAN-MEI WOO
Practice Location Address:

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1609737196 — MAIN SEN KOO
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1407284912 — STELLAR PHYSICAL & OCCUPATIONAL THERAPY & ACUPUNCTURE, PLLC
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Directions to “ WAN MEI WOO L.AC” Practice Location

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