MEDICARE: RIVER PARK 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	:	1578392536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER PARK ACUPUNCTURE P.C.

Provider Business Mailing Address
First Line	:	381 2ND ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-2403
Country	:	US
Telephone Number	:	917-596-5379
Fax Number	:

Provider Business Practice Location Address
First Line	:	900B EAST TREMONT AVE
Second Line	:	SUIT # B
City	:	BRONX
State	:	NY
Zip	:	10460-4355
Country	:	US
Telephone Number	:	347-918-8822
Fax Number	:	347-918-8821

Authorized Official
Title or Position	:	LICENSED ACUPUNCTURIST
Name	:	ZHENTAO WU
Credential	:	LAC
Telephone Number	:	347-918-8822

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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