Provider Demographics
NPI:1467145698
Name:GREAT NECK TERRACE ACUPUNCTURE PC
Entity Type:Organization
Organization Name:GREAT NECK TERRACE ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:IM HYOP
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:LIC ACUPUNCTURIST
Authorized Official - Phone:718-869-1990
Mailing Address - Street 1:30 VESEY ST RM 1803
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2975
Mailing Address - Country:US
Mailing Address - Phone:212-267-1700
Mailing Address - Fax:
Practice Address - Street 1:30 VESEY ST RM 1803
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2975
Practice Address - Country:US
Practice Address - Phone:212-267-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty