MEDICARE: JUN MIN JIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	004918	NY

General Provider Information

NPI Number	:	1952782526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUN MIN JIN

Provider Business Mailing Address
First Line	:	7119 NANSEN ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6729
Country	:	US
Telephone Number	:	917-502-3328
Fax Number	:

Provider Business Practice Location Address
First Line	:	7119 NANSEN ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6729
Country	:	US
Telephone Number	:	917-502-3328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2015
Last Update Date	:	06/09/2015

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Directions to “ JUN MIN JIN ” Practice Location

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