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NPI Code Detail

MEDICARE: YWACUPUNCTURIST PC

MEDICARE: YWACUPUNCTURIST PC
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
1171100000XAcupuncturist002400NY

General Provider Information

NPI Number : 1558701573
Entity Type Code : Organization
Provider Name (Legal Business Name) : YWACUPUNCTURIST PC
Provider Business Mailing Address
First Line : 2 PINE WEST PLAZA
Second Line : WASHINGTON AVE EXT
City : ALBANY
State : NY
Zip : 12205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 PINE WEST PLZ
Second Line : WASHINGTON AVE EXT
City : ALBANY
State : NY
Zip : 12205-5532
Country : US
Telephone Number : 518-690-2008
Fax Number :
Authorized Official
Title or Position : OWNER
Name : YARONG WANG
Credential :
Telephone Number : 518-690-2008
Provider Enumeration Date : 07/05/2013
Last Update Date : 07/05/2013

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