Provider Demographics
NPI:1427563162
Name:SUFFOLK ACUPUNCTURE WELLNESS P.C
Entity Type:Organization
Organization Name:SUFFOLK ACUPUNCTURE WELLNESS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LA.C
Authorized Official - Prefix:
Authorized Official - First Name:EUNKYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-608-5033
Mailing Address - Street 1:800 VETERANS MEMORIAL HWY STE 120
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2937
Mailing Address - Country:US
Mailing Address - Phone:201-608-5033
Mailing Address - Fax:
Practice Address - Street 1:800 VETERANS MEMORIAL HWY STE 120
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2937
Practice Address - Country:US
Practice Address - Phone:201-608-5033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty