Provider Demographics
NPI:1366095317
Name:WOO, WAN MEI (LAC)
Entity type:Individual
Prefix:
First Name:WAN MEI
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 77TH ST STE 1F
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1935
Mailing Address - Country:US
Mailing Address - Phone:718-458-6391
Mailing Address - Fax:646-365-3210
Practice Address - Street 1:4151 77TH ST STE 1F
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1935
Practice Address - Country:US
Practice Address - Phone:718-458-6391
Practice Address - Fax:646-365-3210
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0199171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist