Provider Demographics
NPI:1699331249
Name:QI, YONG
Entity type:Individual
Prefix:
First Name:YONG
Middle Name:
Last Name:QI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 PARSONS BLVD APT 1H
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4218
Mailing Address - Country:US
Mailing Address - Phone:929-300-6829
Mailing Address - Fax:
Practice Address - Street 1:849 57TH ST STE 8
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3798
Practice Address - Country:US
Practice Address - Phone:718-576-6882
Practice Address - Fax:718-228-4455
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-18
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006523171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist