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General NPI Number Information
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NPI Number | 1396071098
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Entity Type | Organization
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Legal Business Name | UNSOOK PARK'S ACUPUNCTURE P.C
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 46-17 215TH PLACE APT 1B
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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 | 516-442-4077
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Fax | 516-442-2278
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Provider Business Mailing Address
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Address Line | 2001 MARCUS AVE SUITE 95W
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2061
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Country | US
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Telephone | 516-442-4077
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | UNSOOK PARK
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Credential |
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Telephone | 516-442-4077
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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 | 002152
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License Number State | NY
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