MEDICARE: COLUMBIA 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	:	1376887737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBIA ACUPUNCTURE P.C.

Provider Business Mailing Address
First Line	:	613 W 169TH ST
Second Line	:	1ST FL
City	:	NEW YORK
State	:	NY
Zip	:	10032-2914
Country	:	US
Telephone Number	:	212-927-8039
Fax Number	:	718-395-3247

Provider Business Practice Location Address
First Line	:	613 W 169TH ST
Second Line	:	1ST FL
City	:	NEW YORK
State	:	NY
Zip	:	10032-2914
Country	:	US
Telephone Number	:	212-927-8039
Fax Number	:	718-395-3247

Authorized Official
Title or Position	:	ACUPUNTURIST/CEO
Name	:	DR. YANZHU LIU
Credential	:	L.AC., DIPL.AC.
Telephone Number	:	917-951-9168

Provider Enumeration Date	:	11/23/2012
Last Update Date	:	09/25/2018

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