Provider Demographics
NPI:1306960364
Name:DONG, YAJING (L,AC)
Entity type:Individual
Prefix:MRS
First Name:YAJING
Middle Name:
Last Name:DONG
Suffix:
Gender:F
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 54TH ST
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5500
Mailing Address - Country:US
Mailing Address - Phone:212-397-8988
Mailing Address - Fax:212-397-8899
Practice Address - Street 1:205 W 54TH ST
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5500
Practice Address - Country:US
Practice Address - Phone:212-397-8988
Practice Address - Fax:212-397-8899
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000819171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist