Provider Demographics
NPI:1235379843
Name:SUN & MOON ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:SUN & MOON ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-463-2700
Mailing Address - Street 1:16410 NORTHERN BLVD
Mailing Address - Street 2:#204
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2677
Mailing Address - Country:US
Mailing Address - Phone:718-463-2700
Mailing Address - Fax:718-463-6174
Practice Address - Street 1:16410 NORTHERN BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2677
Practice Address - Country:US
Practice Address - Phone:718-463-2700
Practice Address - Fax:718-463-6174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002758-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty