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NPI Code Detail

MEDICARE: MS. JIE SHEN LAC

MEDICARE:  MS. JIE  SHEN  LAC
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
1171100000XAcupuncturist001831NY

General Provider Information

NPI Number : 1962573428
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JIE SHEN LAC
Provider Business Mailing Address
First Line : 11 GLEN ROAD
Second Line :
City : SLOATSBURG
State : NY
Zip : 10974
Country : US
Telephone Number : 845-248-2974
Fax Number : 814-368-5283
Provider Business Practice Location Address
First Line : 11 GLEN RD
Second Line :
City : SLOATSBURG
State : NY
Zip : 10974-1804
Country : US
Telephone Number : 845-248-2974
Fax Number : 814-368-5283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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