Healthcare Provider Details

I. General information

NPI: 1629984935
Provider Name (Legal Business Name): SEO ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19122 NORTHERN BLVD
FLUSHING NY
11358-2829
US

IV. Provider business mailing address

19122 NORTHERN BLVD
FLUSHING NY
11358-2829
US

V. Phone/Fax

Practice location:
  • Phone: 718-886-9090
  • Fax:
Mailing address:
  • Phone: 718-886-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEONGHOON SEO
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 917-254-5663