Provider Demographics
NPI:1740667971
Name:CHUNG PT ACUPUNCTURE, PLLC.
Entity type:Organization
Organization Name:CHUNG PT ACUPUNCTURE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSPT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUNG-YING
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-265-2052
Mailing Address - Street 1:833 58TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3609
Mailing Address - Country:US
Mailing Address - Phone:718-290-2919
Mailing Address - Fax:
Practice Address - Street 1:315 W 57TH ST STE 315
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3147
Practice Address - Country:US
Practice Address - Phone:212-265-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022918174400000X
NY033314174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03291210Medicaid
NY02976158Medicaid
NYA400078401Medicare PIN
NY03291210Medicaid
NYA400088009Medicare PIN