Healthcare Provider Details

I. General information

NPI: 1588947774
Provider Name (Legal Business Name): KYUNG YUN SHUMAKER LIC ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KYUNG YUN KIM RPH

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 OLD YORK RD 333
JENKINTOWN PA
19046
US

IV. Provider business mailing address

7437 COVENTRY AVE
MELROSE PARK PA
19027
US

V. Phone/Fax

Practice location:
  • Phone: 215-887-3712
  • Fax:
Mailing address:
  • Phone: 215-635-6549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034735L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK001011
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: