Provider Demographics
NPI:1003563354
Name:CHUNG, HANNAH HAEUN (LAC, LMT)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:HAEUN
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E 90TH ST APT 1W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1569
Mailing Address - Country:US
Mailing Address - Phone:646-609-4250
Mailing Address - Fax:
Practice Address - Street 1:129 E 90TH ST APT 1W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1569
Practice Address - Country:US
Practice Address - Phone:646-609-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006989171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty