Provider Demographics
NPI:1346875655
Name:JEONG SEO ACUPUNTURE, P.C.
Entity Type:Organization
Organization Name:JEONG SEO ACUPUNTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-353-3988
Mailing Address - Street 1:16326 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2645
Mailing Address - Country:US
Mailing Address - Phone:718-353-3988
Mailing Address - Fax:
Practice Address - Street 1:16326 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2645
Practice Address - Country:US
Practice Address - Phone:718-353-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty