MEDICARE: EZ ACUPUNCTURE 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
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1942016266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZ ACUPUNCTURE PC

Provider Business Mailing Address
First Line	:	58 RENKEN BLVD # 2
Second Line	:
City	:	FRANKLIN SQUARE
State	:	NY
Zip	:	11010-2757
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 NEW YORK AVE
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-1727
Country	:	US
Telephone Number	:	631-837-3376
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TONY YAM
Credential	:	L.AC
Telephone Number	:	631-837-3376

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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