Provider Demographics
NPI:1598239253
Name:CAI, JINGHUAN
Entity Type:Individual
Prefix:
First Name:JINGHUAN
Middle Name:
Last Name:CAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:CAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3519 149TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3740
Mailing Address - Country:US
Mailing Address - Phone:626-271-4893
Mailing Address - Fax:
Practice Address - Street 1:14307 SANFORD AVE APT 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2001
Practice Address - Country:US
Practice Address - Phone:626-271-4893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist