Provider Demographics
NPI:1568237337
Name:RISING TIDE ACUPUNCTURE PC
Entity Type:Organization
Organization Name:RISING TIDE ACUPUNCTURE PC
Other - Org Name:EAST TO WEST ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-416-4940
Mailing Address - Street 1:607 W JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6362
Mailing Address - Country:US
Mailing Address - Phone:631-416-4940
Mailing Address - Fax:631-479-3337
Practice Address - Street 1:607 W JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6362
Practice Address - Country:US
Practice Address - Phone:631-416-4940
Practice Address - Fax:631-479-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty