1225151350 NPI number — TREE OF LIFE ACUPUNCTURE, P.C.

Table of content: (NPI 1225151350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225151350 NPI number — TREE OF LIFE ACUPUNCTURE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TREE OF LIFE ACUPUNCTURE, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225151350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2935 W 5TH ST
Provider Second Line Business Mailing Address:
APT 21H
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11224-3965
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-533-1192
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 UNION SQ E
Provider Second Line Business Practice Location Address:
ROOM 804
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-533-1192
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOSHCHINSKY
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
ACUPUNCTURIST
Authorized Official Telephone Number:
212-533-1192

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  000445 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com