Provider Demographics
NPI:1164997607
Name:CC ACUPUNCTURE PC
Entity Type:Organization
Organization Name:CC ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHEYU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-431-7400
Mailing Address - Street 1:6918 242ND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1946
Mailing Address - Country:US
Mailing Address - Phone:646-431-7400
Mailing Address - Fax:
Practice Address - Street 1:6918 242ND ST FL 3
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-1946
Practice Address - Country:US
Practice Address - Phone:646-431-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty