Provider Demographics
NPI:1639504483
Name:MANNA ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:MANNA ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LU-WONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LAC, RMT
Authorized Official - Phone:914-419-2223
Mailing Address - Street 1:22 CHERRYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1102
Mailing Address - Country:US
Mailing Address - Phone:914-419-2223
Mailing Address - Fax:914-337-5533
Practice Address - Street 1:22 CHERRYWOOD RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1102
Practice Address - Country:US
Practice Address - Phone:914-419-2223
Practice Address - Fax:914-337-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004087171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty