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General NPI Number Information
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NPI Number | 1881042687
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Entity Type | Organization
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Legal Business Name | 410 ACUPUNCTURE PC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 9050 PARSONS BVLD STE 410
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City | JAMAICA
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State | NY
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Zip | 11432-6012
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Country | US
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Telephone | 718-687-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 9050 PARSONS BVLD STE 410
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City | JAMAICA
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State | NY
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Zip | 11432-6012
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Country | US
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Telephone | 718-687-2474
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | YUNJI LEE
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Credential |
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Telephone | 718-687-2474
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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 | 5195
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License Number State | NY
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