Provider Demographics
NPI:1720410335
Name:SIP, WAIPING (LAC)
Entity Type:Individual
Prefix:MISS
First Name:WAIPING
Middle Name:
Last Name:SIP
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E SHORE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2437
Mailing Address - Country:US
Mailing Address - Phone:917-426-9297
Mailing Address - Fax:
Practice Address - Street 1:175 E SHORE RD STE 302
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2437
Practice Address - Country:US
Practice Address - Phone:917-426-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist