Provider Demographics
NPI:1720086259
Name:PI, JIAN
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:
Last Name:PI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24565 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2022
Mailing Address - Country:US
Mailing Address - Phone:718-229-4526
Mailing Address - Fax:
Practice Address - Street 1:3366 PARK AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3718
Practice Address - Country:US
Practice Address - Phone:516-409-8126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist