Provider Demographics
NPI:1417291741
Name:SUN WELLNESS ACUPUNCTURE PC
Entity Type:Organization
Organization Name:SUN WELLNESS ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUNYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-327-1812
Mailing Address - Street 1:1208B VFW PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4350
Mailing Address - Country:US
Mailing Address - Phone:617-327-1812
Mailing Address - Fax:855-327-1812
Practice Address - Street 1:1208B VFW PKWY STE 201
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-4350
Practice Address - Country:US
Practice Address - Phone:617-327-1812
Practice Address - Fax:855-327-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242074302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization