Provider Demographics
NPI:1255895157
Name:RED PANDA ACUPUNCTURE LLC
Entity type:Organization
Organization Name:RED PANDA ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KEARNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFILLIPO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:215-259-8180
Mailing Address - Street 1:931 WASHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 YORK RD STE 210
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3262
Practice Address - Country:US
Practice Address - Phone:215-259-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty