MEDICARE: BK ACUPUNCTURE, P.C.

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	:	1710619234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BK ACUPUNCTURE, P.C.

Provider Business Mailing Address
First Line	:	1648 E 14TH ST STE 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1175
Country	:	US
Telephone Number	:	929-428-1750
Fax Number	:	718-676-0609

Provider Business Practice Location Address
First Line	:	1648 E 14TH ST STE 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1175
Country	:	US
Telephone Number	:	929-428-1750
Fax Number	:	718-676-0609

Authorized Official
Title or Position	:	OWNER
Name	:	BYONGSUK KIM
Credential	:
Telephone Number	:	929-428-1750

Provider Enumeration Date	:	06/24/2022
Last Update Date	:	06/24/2022

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