Provider Demographics
NPI:1265608814
Name:ULTIMATE HEALING & ACUPUNCTURE PC
Entity type:Organization
Organization Name:ULTIMATE HEALING & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:XIAO
Authorized Official - Middle Name:L
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:917-376-6886
Mailing Address - Street 1:401 E 58TH ST
Mailing Address - Street 2:SUITE C6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2312
Mailing Address - Country:US
Mailing Address - Phone:917-376-6886
Mailing Address - Fax:
Practice Address - Street 1:230 MIDDLE NECK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1113
Practice Address - Country:US
Practice Address - Phone:917-376-6886
Practice Address - Fax:212-688-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-04
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002844171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002844OtherNY STATE LICENSE NUMBER
1104029800OtherPROVIDER NPI