Provider Demographics
NPI:1134519697
Name:PONO ACUPUNCTURE
Entity type:Organization
Organization Name:PONO ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:860-796-2405
Mailing Address - Street 1:1841 DITMARS BLVD
Mailing Address - Street 2:#2B
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3913
Mailing Address - Country:US
Mailing Address - Phone:347-669-5717
Mailing Address - Fax:
Practice Address - Street 1:1841 DITMARS BLVD
Practice Address - Street 2:#2B
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3913
Practice Address - Country:US
Practice Address - Phone:347-669-5717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty