Healthcare Provider Details

I. General information

NPI: 1164333563
Provider Name (Legal Business Name): SUNG K KIM ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 21ST AVE FL 1
ASTORIA NY
11105-2681
US

IV. Provider business mailing address

2905 21ST AVE FL 1
ASTORIA NY
11105-2681
US

V. Phone/Fax

Practice location:
  • Phone: 646-687-2838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: NABEEL BABAR
Title or Position: ADMINISTRATOR
Credential:
Phone: 646-687-2838