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General NPI Number Information
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NPI Number | 1548803166
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Entity Type | Individual
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Provider Name | JOOWON SEO L.AC
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Gender | Male
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 516 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3006
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Country | US
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Telephone | 646-596-1858
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Fax | 516-775-0548
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Provider Business Mailing Address
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Address Line | 516 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3006
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Country | US
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Telephone | 646-596-1858
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Fax | 516-775-0548
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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 | 005975
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 032205-01
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License Number State | NY
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