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General NPI Number Information
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NPI Number | 1124346192
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Entity Type | Organization
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Legal Business Name | FOUR SEASONS ACUPUNCTURE, P.C.
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 27 W COLUMBIA ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-2429
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Country | US
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Telephone | 516-489-2626
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Fax | 877-719-0709
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Provider Business Mailing Address
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Address Line | 14 REDWOOD DR
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City | PLAINVIEW
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State | NY
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Zip | 11803-5215
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Country | US
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Telephone | 646-642-2908
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SANGWON LEE
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Credential | LAC
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Telephone | 646-642-2908
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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 |
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License Number State |
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