Provider Demographics
NPI:1891935409
Name:YOU, HAISHU (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MRS
First Name:HAISHU
Middle Name:
Last Name:YOU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:MRS
Other - First Name:HAISHU
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:215 TUDOR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1630
Mailing Address - Country:US
Mailing Address - Phone:215-654-9038
Mailing Address - Fax:
Practice Address - Street 1:5919 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1823
Practice Address - Country:US
Practice Address - Phone:215-924-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK00664171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232859584Medicare PIN
PA232859584Medicare UPIN