MEDICARE: WOO ACUPUNCTURE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1376172270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOO ACUPUNCTURE PC

Provider Business Mailing Address
First Line	:	25220 NORTHERN BLVD STE 202
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-1344
Country	:	US
Telephone Number	:	347-836-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	25220 NORTHERN BLVD STE 202
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-1344
Country	:	US
Telephone Number	:	347-836-8914
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	MR. JEHYUN WOO
Credential	:
Telephone Number	:	347-836-8914

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	04/03/2020

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