Provider Demographics
NPI:1184017824
Name:JIAN, PEIYU (LAC)
Entity Type:Individual
Prefix:MS
First Name:PEIYU
Middle Name:
Last Name:JIAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 W168TH ST APT2
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-927-8029
Mailing Address - Fax:718-395-3247
Practice Address - Street 1:13 E37TH ST #412
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-685-0888
Practice Address - Fax:718-395-3247
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005491171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist