Healthcare Provider Details

I. General information

NPI: 1538452644
Provider Name (Legal Business Name): SEOUL ACUPUNCTURE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W 32ND ST STE 1007
NEW YORK NY
10001-3880
US

IV. Provider business mailing address

38 W 32ND ST STE 1007
NEW YORK NY
10001-3880
US

V. Phone/Fax

Practice location:
  • Phone: 212-539-5559
  • Fax:
Mailing address:
  • Phone: 212-539-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AI JA LEE
Title or Position: PRESIDENT
Credential: L.AC
Phone: 212-239-5559