1396071098 NPI number — UNSOOK PARK'S ACUPUNCTURE P.C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396071098 NPI number — UNSOOK PARK'S ACUPUNCTURE P.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNSOOK PARK'S ACUPUNCTURE P.C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396071098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 MARCUS AVE
Provider Second Line Business Mailing Address:
SUITE 95W
Provider Business Mailing Address City Name:
NEW HYDE PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11042-2061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-442-4077
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46-17 215TH PLACE
Provider Second Line Business Practice Location Address:
APT 1B
Provider Business Practice Location Address City Name:
BAYSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-442-4077
Provider Business Practice Location Address Fax Number:
516-442-2278
Provider Enumeration Date:
10/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PARK
Authorized Official First Name:
UNSOOK
Authorized Official Middle Name:
Authorized Official Title or Position:
ACUPUNCTURIST
Authorized Official Telephone Number:
516-442-4077

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  002152 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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