Provider Demographics
NPI:1366059255
Name:SHINE ACUPUNCTURE WELLNESS PLLC
Entity type:Organization
Organization Name:SHINE ACUPUNCTURE WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAC, OM / CHIEF OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MEEI MIAW
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DAOM
Authorized Official - Phone:914-819-2713
Mailing Address - Street 1:128 FORT WASHINGTON AVE APT J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4735
Mailing Address - Country:US
Mailing Address - Phone:212-568-5100
Mailing Address - Fax:212-568-5105
Practice Address - Street 1:128 FORT WASHINGTON AVE APT J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4735
Practice Address - Country:US
Practice Address - Phone:212-568-5100
Practice Address - Fax:212-568-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty