Provider Demographics
NPI:1245497379
Name:ACTIVE ACUPUNCTURE PC
Entity type:Organization
Organization Name:ACTIVE ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ZHAOYANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED ACUPUNCTURI
Authorized Official - Phone:212-974-2880
Mailing Address - Street 1:119 W 57TH STREET
Mailing Address - Street 2:SUITE 511
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-974-2880
Mailing Address - Fax:212-974-2418
Practice Address - Street 1:119 W 57TH STREET
Practice Address - Street 2:SUITE 511
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-974-2880
Practice Address - Fax:212-974-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS000369171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty