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General NPI Number Information
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NPI Number | 1710007265
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Entity Type | Organization
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Legal Business Name | BLUE SKY ACUPUNCTURE P.C.
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2676 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10458-4914
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Country | US
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Telephone | 718-733-1000
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Fax | 718-733-0351
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Provider Business Mailing Address
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Address Line | 2676 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10458-4914
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Country | US
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Telephone | 718-733-1000
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Fax | 718-733-0351
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JIM CHI-SHEN SUNG
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Credential | L. AC.
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Telephone | 718-733-1000
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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 | 002074
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License Number State | NY
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