Provider Demographics
NPI:1528130564
Name:ELEMENT ACUPUNCTURE HEALING ARTS
Entity type:Organization
Organization Name:ELEMENT ACUPUNCTURE HEALING ARTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-855-4850
Mailing Address - Street 1:518 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-5243
Mailing Address - Country:US
Mailing Address - Phone:718-855-4850
Mailing Address - Fax:718-855-4860
Practice Address - Street 1:518 HENRY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-5243
Practice Address - Country:US
Practice Address - Phone:718-855-4850
Practice Address - Fax:718-855-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1720171100000X
NY1640171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2640834OtherOXFORD PROVIDER #
NYP2640838OtherOXFORD PROVIDER #