Provider Demographics
NPI:1720426612
Name:XIJING ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:XIJING ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-662-2586
Mailing Address - Street 1:14480 SANFORD AVE
Mailing Address - Street 2:APT 1H
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1600
Mailing Address - Country:US
Mailing Address - Phone:646-662-2586
Mailing Address - Fax:212-781-8859
Practice Address - Street 1:651 W 180TH ST
Practice Address - Street 2:#2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4802
Practice Address - Country:US
Practice Address - Phone:646-662-2586
Practice Address - Fax:212-781-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001951305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service