MEDICARE: QI WELLNESS CENTER, LLC

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	003461	NY

General Provider Information

NPI Number	:	1447421417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QI WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	14105 33RD AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3137
Country	:	US
Telephone Number	:	718-886-6898
Fax Number	:	718-886-1949

Provider Business Practice Location Address
First Line	:	14105 33RD AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3137
Country	:	US
Telephone Number	:	718-886-6898
Fax Number	:	718-886-1949

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	VICKI QI
Credential	:
Telephone Number	:	718-886-6898

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	03/18/2008

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