Provider Demographics
NPI:1053910133
Name:BETHEL HOLISTIC HEALTH
Entity type:Organization
Organization Name:BETHEL HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HOIYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TING
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:203-558-6169
Mailing Address - Street 1:142C GRASSY PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-4800
Mailing Address - Country:US
Mailing Address - Phone:203-558-6169
Mailing Address - Fax:
Practice Address - Street 1:142C GRASSY PLAIN ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-4800
Practice Address - Country:US
Practice Address - Phone:203-558-6169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty