Provider Demographics
NPI:1629637863
Name:FIFTH AVENUE ACUP HEALTH INC
Entity Type:Organization
Organization Name:FIFTH AVENUE ACUP HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MAN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-861-2060
Mailing Address - Street 1:2 W 45TH ST STE 1702
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4221
Mailing Address - Country:US
Mailing Address - Phone:646-861-2060
Mailing Address - Fax:646-861-2041
Practice Address - Street 1:2 W 45TH ST STE 1702
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4221
Practice Address - Country:US
Practice Address - Phone:646-861-2060
Practice Address - Fax:646-861-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0768OtherACUPUNCTURE