Provider Demographics
NPI:1801001664
Name:NEW YORK ACUPUNCTURE & PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:NEW YORK ACUPUNCTURE & PHYSICAL THERAPY CENTER
Other - Org Name:ACUPUNCTURE & HERBAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAYI
Authorized Official - Middle Name:
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-627-6812
Mailing Address - Street 1:1906 KINGS HWY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1314
Mailing Address - Country:US
Mailing Address - Phone:718-627-6812
Mailing Address - Fax:
Practice Address - Street 1:1906 KINGS HWY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1314
Practice Address - Country:US
Practice Address - Phone:718-627-6812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000738171100000X
NY000964171100000X
NY023574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ1WWY1Medicare ID - Type Unspecified