Provider Demographics
NPI:1619496528
Name:SOPHIE YOUNG ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:SOPHIE YOUNG ACUPUNCTURE PLLC
Other - Org Name:CITY ACUPUNCTURE COLUMBUS CIRCLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSTOM
Authorized Official - Phone:917-446-5275
Mailing Address - Street 1:141A DIAMOND ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-3995
Mailing Address - Country:US
Mailing Address - Phone:917-446-5275
Mailing Address - Fax:
Practice Address - Street 1:140 WEST 58THST
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2120
Practice Address - Country:US
Practice Address - Phone:646-216-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2017-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005632171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty