Provider Demographics
NPI:1598915845
Name:BOOK KYUNG HOLISTIC CENTER, PC
Entity Type:Organization
Organization Name:BOOK KYUNG HOLISTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-313-0501
Mailing Address - Street 1:45 BROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1443
Mailing Address - Country:US
Mailing Address - Phone:201-313-0501
Mailing Address - Fax:201-313-1454
Practice Address - Street 1:45 BROAD AVENUE
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1443
Practice Address - Country:US
Practice Address - Phone:201-313-0501
Practice Address - Fax:201-313-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00019800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty