Provider Demographics
NPI:1558896373
Name:WOO, JEHYUN (LAC)
Entity Type:Individual
Prefix:
First Name:JEHYUN
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20935 NORTHERN BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3134
Mailing Address - Country:US
Mailing Address - Phone:718-225-9000
Mailing Address - Fax:718-352-9000
Practice Address - Street 1:25220 NORTHERN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1344
Practice Address - Country:US
Practice Address - Phone:347-836-8914
Practice Address - Fax:478-354-8703
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-30
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005752171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist