Provider Demographics
NPI:1043910375
Name:JS ACUPUNCTURE & MASSAGE THERAPY PC
Entity Type:Organization
Organization Name:JS ACUPUNCTURE & MASSAGE THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOOWON
Authorized Official - Middle Name:
Authorized Official - Last Name:SEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-596-1858
Mailing Address - Street 1:370 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2106
Mailing Address - Country:US
Mailing Address - Phone:646-596-1858
Mailing Address - Fax:
Practice Address - Street 1:370 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2106
Practice Address - Country:US
Practice Address - Phone:646-596-1858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY032205-01OtherMASSAGE THERAPY