Provider Demographics
NPI:1356008650
Name:JIN, QIHUI (LAC)
Entity type:Individual
Prefix:
First Name:QIHUI
Middle Name:
Last Name:JIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:QIHUI
Other - Middle Name:
Other - Last Name:JIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 HILLARY CT
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6148
Mailing Address - Country:US
Mailing Address - Phone:202-779-7040
Mailing Address - Fax:
Practice Address - Street 1:2 HILLARY CT
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6148
Practice Address - Country:US
Practice Address - Phone:202-779-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006946171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist