Provider Demographics
NPI:1225151350
Name:TREE OF LIFE ACUPUNCTURE, P.C.
Entity Type:Organization
Organization Name:TREE OF LIFE ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHCHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC (NCCAOM)
Authorized Official - Phone:212-533-1192
Mailing Address - Street 1:2935 W 5TH ST
Mailing Address - Street 2:APT 21H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3965
Mailing Address - Country:US
Mailing Address - Phone:212-533-1192
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E
Practice Address - Street 2:ROOM 804
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3209
Practice Address - Country:US
Practice Address - Phone:212-533-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty