Provider Demographics
NPI:1154838001
Name:SUN JIN ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:SUN JIN ACUPUNCTURE P.C.
Other - Org Name:SUN JIN ACUPUNCTURE P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LAC
Authorized Official - Prefix:MR
Authorized Official - First Name:JONG
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-214-1632
Mailing Address - Street 1:160 HOWELLS RD STE 28
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5320
Mailing Address - Country:US
Mailing Address - Phone:917-214-1632
Mailing Address - Fax:973-947-2421
Practice Address - Street 1:160 HOWELLS RD STE 28
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5320
Practice Address - Country:US
Practice Address - Phone:917-214-1632
Practice Address - Fax:973-947-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005811171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty