Provider Demographics
NPI:1538990361
Name:MINGLU YAN ACUPUNCTURE PC
Entity type:Organization
Organization Name:MINGLU YAN ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINGLU
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:917-238-0905
Mailing Address - Street 1:61 MAINE AVE APT E15
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3633
Mailing Address - Country:US
Mailing Address - Phone:917-238-0905
Mailing Address - Fax:
Practice Address - Street 1:2 W 45TH ST STE 1002
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4253
Practice Address - Country:US
Practice Address - Phone:917-238-0905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty