Provider Demographics
NPI:1356657555
Name:HONG, SUNJOO (L,AC)
Entity Type:Individual
Prefix:MS
First Name:SUNJOO
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2508
Mailing Address - Country:US
Mailing Address - Phone:845-359-1201
Mailing Address - Fax:845-359-1251
Practice Address - Street 1:124 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2508
Practice Address - Country:US
Practice Address - Phone:845-359-1201
Practice Address - Fax:845-359-1251
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004344171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist