Basic Information
| Provider Information | |||||||||
| NPI: | 1114292745 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JIANG'S ACUPUNCTURE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 520391 | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113520391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188868180 | ||||||||
| FaxNumber: | 7188868183 | ||||||||
| Practice Location | |||||||||
| Address1: | 9429 75TH ST | ||||||||
| Address2: | |||||||||
| City: | OZONE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114161005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188868180 | ||||||||
| FaxNumber: | 7188868183 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2012 | ||||||||
| LastUpdateDate: | 03/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | JIANG | ||||||||
| AuthorizedOfficialFirstName: | XIAO | ||||||||
| AuthorizedOfficialMiddleName: | YAN | ||||||||
| AuthorizedOfficialTitleorPosition: | ACUPUNCTURE | ||||||||
| AuthorizedOfficialTelephone: | 7188868180 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LIC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | 00261 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.