Provider Demographics
NPI:1407651805
Name:REISHI ACUPUNCTURE AND MASSAGE THERAPY PLLC
Entity type:Organization
Organization Name:REISHI ACUPUNCTURE AND MASSAGE THERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:L.AC
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-779-1054
Mailing Address - Street 1:535 BROADHOLLOW RD STE B12
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3701
Mailing Address - Country:US
Mailing Address - Phone:516-779-1054
Mailing Address - Fax:
Practice Address - Street 1:535 BROADHOLLOW RD STE B12
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3701
Practice Address - Country:US
Practice Address - Phone:516-779-1054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty