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NPI Code Detail

MEDICARE: MR. YOUNG CHUN KUM R.PH., L.AC.

MEDICARE: MR. YOUNG CHUN KUM R.PH., L.AC.
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
1171100000XAcupuncturist001079NY
2183500000XPharmacist036122NY

General Provider Information

NPI Number : 1629187224
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. YOUNG CHUN KUM R.PH., L.AC.
Provider Business Mailing Address
First Line : 53 FRASER ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6111
Country : US
Telephone Number : 718-494-3035
Fax Number :
Provider Business Practice Location Address
First Line : 1225 GERARD AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-8001
Country : US
Telephone Number : 718-960-2772
Fax Number : 718-960-2628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 09/11/2025

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