Healthcare Provider Details

I. General information

NPI: 1104741255
Provider Name (Legal Business Name): HANSUNG JEON ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MILLER BLVD
SYOSSET NY
11791-3511
US

IV. Provider business mailing address

19 MILLER BLVD
SYOSSET NY
11791-3511
US

V. Phone/Fax

Practice location:
  • Phone: 929-401-7186
  • Fax:
Mailing address:
  • Phone: 929-401-7186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. HANSUNG JEON
Title or Position: PRESIDENT
Credential: L.AC
Phone: 929-401-7186