Provider Demographics
NPI:1326479445
Name:TAEBAEK ACUPUNCTURE P.C
Entity Type:Organization
Organization Name:TAEBAEK ACUPUNCTURE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WON
Authorized Official - Middle Name:BAEK
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-225-0077
Mailing Address - Street 1:4224 213TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2853
Mailing Address - Country:US
Mailing Address - Phone:718-225-0077
Mailing Address - Fax:
Practice Address - Street 1:4224 213TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2853
Practice Address - Country:US
Practice Address - Phone:718-225-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-30
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002702171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty