1487248647 NPI number — HEALING ACUPUNCTURE ARTS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487248647 NPI number — HEALING ACUPUNCTURE ARTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING ACUPUNCTURE ARTS, PC
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:
1487248647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 OCEANA DR E APT 4G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11235-6685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-402-1792
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
185 CENTRAL AVE STE 311
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07018-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-402-1792
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GLEYZER
Authorized Official First Name:
GRIGORIY
Authorized Official Middle Name:
Authorized Official Title or Position:
LICENSED ACUPUNCTURIST
Authorized Official Telephone Number:
646-402-1792

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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