Provider Demographics
NPI:1811533714
Name:MA, RISHENG (LAC)
Entity type:Individual
Prefix:
First Name:RISHENG
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 ANDERSON AVE APT B
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2713
Mailing Address - Country:US
Mailing Address - Phone:347-366-1084
Mailing Address - Fax:
Practice Address - Street 1:1570 ANDERSON AVE APT B
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-2713
Practice Address - Country:US
Practice Address - Phone:347-366-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006594171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist