Provider Demographics
NPI:1922682467
Name:APOLLO WELLNESS CORP
Entity Type:Organization
Organization Name:APOLLO WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIQUN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-886-3588
Mailing Address - Street 1:4160 MAIN ST STE 305A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3894
Mailing Address - Country:US
Mailing Address - Phone:718-886-3588
Mailing Address - Fax:
Practice Address - Street 1:4160 MAIN ST STE 305A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3894
Practice Address - Country:US
Practice Address - Phone:718-886-3588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty