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General NPI Number Information
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NPI Number | 1154963981
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Entity Type | Individual
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Provider Name | SO YONG HA
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 9851 64TH AVE
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City | REGO PARK
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State | NY
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Zip | 11374-2520
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Country | US
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Telephone | 718-275-6968
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Fax |
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Provider Business Mailing Address
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Address Line | 2065 41ST ST APT 2
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City | ASTORIA
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State | NY
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Zip | 11105-1613
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Country | US
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Telephone | 914-309-8356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6282
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License Number State | NY
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