Healthcare Provider Details

I. General information

NPI: 1508318601
Provider Name (Legal Business Name): PATIENT CHOICE ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16110 JAMAICA AVE SUITE 301
JAMAICA NY
11432-6139
US

IV. Provider business mailing address

16110 JAMAICA AVE SUITE 301
JAMAICA NY
11432-6139
US

V. Phone/Fax

Practice location:
  • Phone: 929-249-3700
  • Fax: 929-295-7032
Mailing address:
  • Phone: 929-249-3700
  • Fax: 929-295-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005706
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032243
License Number StateNY

VIII. Authorized Official

Name: DR. SUNGIL HONG
Title or Position: OWNER
Credential:
Phone: 917-889-4001