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General NPI Number Information
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NPI Number | 1205651650
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Entity Type | Organization
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Legal Business Name | SOHO CHIROPRACTIC PC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 147 W 25TH ST FL 7
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City | NEW YORK
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State | NY
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Zip | 10001-7270
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Country | US
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Telephone | 212-206-1603
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Fax | 212-206-1541
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Provider Business Mailing Address
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Address Line | 248 BELLEMEADE AVE
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City | FORT LEE
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State | NJ
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Zip | 07024-4306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | SOOYEON GIM
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Credential | DC
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Telephone | 347-653-2497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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