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General NPI Number Information
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NPI Number | 1275993206
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Entity Type | Organization
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Legal Business Name | GAON ACUPUNCTURE, P.C.
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 17325 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5523
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Country | US
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Telephone | 718-285-6054
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Fax |
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Provider Business Mailing Address
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Address Line | 17543 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5724
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Country | US
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Telephone | 646-413-2200
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | YOUNGJUN YOUN
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Credential | LAC
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Telephone | 646-641-3220
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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 | NY
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