Provider Demographics
NPI:1548973936
Name:XIU JUAN LI ACUPUNCTURE PC
Entity type:Organization
Organization Name:XIU JUAN LI ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:XIU JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-717-3562
Mailing Address - Street 1:968 60TH ST APT 310
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4858
Mailing Address - Country:US
Mailing Address - Phone:646-717-3562
Mailing Address - Fax:
Practice Address - Street 1:834 57TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3682
Practice Address - Country:US
Practice Address - Phone:646-717-3562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty