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NPI Code Detail

MEDICARE: SYNERGY ACUPUNCTURE PC

MEDICARE: SYNERGY 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
1171100000XAcupuncturist003056NY

General Provider Information

NPI Number : 1700376233
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYNERGY ACUPUNCTURE PC
Provider Business Mailing Address
First Line : 11442 SUTPHIN BLVD # 1
Second Line :
City : JAMAICA
State : NY
Zip : 11434-1021
Country : US
Telephone Number : 929-499-3172
Fax Number : 929-499-3170
Provider Business Practice Location Address
First Line : 11442 SUTPHIN BLVD # 1
Second Line :
City : JAMAICA
State : NY
Zip : 11434-1021
Country : US
Telephone Number : 929-499-3172
Fax Number : 929-499-3170
Authorized Official
Title or Position : OWNER
Name : OKKYOUNG PARK-KIM
Credential : LAC
Telephone Number : 929-499-3172
Provider Enumeration Date : 05/10/2018
Last Update Date : 05/10/2018

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Directions to “SYNERGY ACUPUNCTURE PC ” Practice Location

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