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NPI Code Detail

MEDICARE: PROF. AIZHONG LI ACUPUNCTURIST

MEDICARE: PROF. AIZHONG LI ACUPUNCTURIST
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
1171100000XAcupuncturist003102NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003102OTHERNYNEY YORK STATE LICENSE
27049746OTHERNYAETNA
35474095OTHERNYNY REGISTRATION NUMBER
411510418OTHERNYCAQH

General Provider Information

NPI Number : 1699738609
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. AIZHONG LI ACUPUNCTURIST
Provider Business Mailing Address
First Line : 2360 STATE ROUTE 89
Second Line : AOM
City : SENECA FALLS
State : NY
Zip : 13148-9425
Country : US
Telephone Number : 315-568-3177
Fax Number : 131-556-8301
Provider Business Practice Location Address
First Line : 2360 STATE ROUTE 89
Second Line : AOM
City : SENECA FALLS
State : NY
Zip : 13148-9425
Country : US
Telephone Number : 315-568-3177
Fax Number : 131-556-8301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/08/2007

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Directions to “ PROF. AIZHONG LI ACUPUNCTURIST” Practice Location

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