Provider Demographics
NPI:1235655374
Name:SHU, KEE (LAC)
Entity Type:Individual
Prefix:
First Name:KEE
Middle Name:
Last Name:SHU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:KEE
Other - Middle Name:
Other - Last Name:SHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JACKEE SHU
Mailing Address - Street 1:119 W 23RD ST STE 407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6369
Mailing Address - Country:US
Mailing Address - Phone:914-341-2993
Mailing Address - Fax:
Practice Address - Street 1:119 W 23RD ST STE 407
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6369
Practice Address - Country:US
Practice Address - Phone:914-341-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist