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General NPI Number Information
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NPI Number | 1063908531
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Entity Type | Organization
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Legal Business Name | HONGIK ACUPUNCTURE N.Y. P.C.
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 21441 42ND AVE STE 4C
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City | BAYSIDE
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State | NY
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Zip | 11361
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Country | US
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Telephone | 718-316-8663
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Fax |
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Provider Business Mailing Address
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Address Line | 21441 42ND AVE STE 4C
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City | BAYSIDE
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State | NY
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Zip | 11361-2963
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Country | US
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Telephone | 718-316-8663
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AEJA KIM
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Credential |
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Telephone | 718-316-8663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 2546-1
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License Number State | NY
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