Provider Demographics
NPI:1700391737
Name:LOTUS BLOSSOM ACUPUNCTURE PC
Entity Type:Organization
Organization Name:LOTUS BLOSSOM ACUPUNCTURE PC
Other - Org Name:LOTUS HEALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER,MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:QIANQIU
Authorized Official - Middle Name:LOTUS
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-282-2978
Mailing Address - Street 1:353 LEXINTON AVENUE
Mailing Address - Street 2:#1205
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:347-282-2978
Mailing Address - Fax:347-368-0598
Practice Address - Street 1:353 LEXINTON AVENUE
Practice Address - Street 2:1205
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10016-0031
Practice Address - Country:US
Practice Address - Phone:347-405-4558
Practice Address - Fax:347-368-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006001171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty