Provider Demographics
NPI:1306361589
Name:LYEW, KWANGHEE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:KWANGHEE
Middle Name:
Last Name:LYEW
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N BROADWAY STE 206
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2657
Mailing Address - Country:US
Mailing Address - Phone:914-522-0536
Mailing Address - Fax:
Practice Address - Street 1:245 N BROADWAY STE 206
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2657
Practice Address - Country:US
Practice Address - Phone:914-522-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005692171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist