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General NPI Number Information
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NPI Number | 1689378648
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Entity Type | Organization
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Legal Business Name | GOOD VIBES ACUPUNCTURE AND MASSAGE THERAPY PC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 16326 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11358-2645
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Country | US
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Telephone | 917-915-1138
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 192ND ST APT 412
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3735
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Country | US
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Telephone | 917-915-1138
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | SUHYUN AHN
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Credential |
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Telephone | 917-915-1138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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