Provider Demographics
NPI:1972847762
Name:WELLCARE ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:WELLCARE ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANG XIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-283-5146
Mailing Address - Street 1:7-8 CHATHAM SQUARE
Mailing Address - Street 2:SUITE 707
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038
Mailing Address - Country:US
Mailing Address - Phone:212-962-0711
Mailing Address - Fax:212-962-0822
Practice Address - Street 1:7-8 CHATHAM SQ
Practice Address - Street 2:SUITE 707
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1000
Practice Address - Country:US
Practice Address - Phone:646-283-5146
Practice Address - Fax:212-962-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003672302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization