Provider Demographics
NPI:1730204017
Name:EAST WEST NATURAL HEALTH CENTER
Entity type:Organization
Organization Name:EAST WEST NATURAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:XUE MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DIPL OM
Authorized Official - Phone:1718-986-5304
Mailing Address - Street 1:1780 BROADWAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1414
Mailing Address - Country:US
Mailing Address - Phone:212-581-1074
Mailing Address - Fax:212-245-4800
Practice Address - Street 1:1780 BROADWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1414
Practice Address - Country:US
Practice Address - Phone:212-581-1074
Practice Address - Fax:212-245-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001212302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization