Healthcare Provider Details

I. General information

NPI: 1891809000
Provider Name (Legal Business Name): UNE-HI SONG M.S., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W. PASSAIC ST STE 8
MAYWOOD NJ
07607-1264
US

IV. Provider business mailing address

240 W. PASSAIC ST STE 8
MAYWOOD NJ
07607-1264
US

V. Phone/Fax

Practice location:
  • Phone: 551-800-1590
  • Fax:
Mailing address:
  • Phone: 551-800-1590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number003219
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00048700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: