Provider Demographics
NPI:1689378648
Name:GOOD VIBES ACUPUNCTURE AND MASSAGE THERAPY PC
Entity Type:Organization
Organization Name:GOOD VIBES ACUPUNCTURE AND MASSAGE THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUHYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-915-1138
Mailing Address - Street 1:6700 192ND ST APT 412
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3735
Mailing Address - Country:US
Mailing Address - Phone:917-915-1138
Mailing Address - Fax:
Practice Address - Street 1:16326 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2645
Practice Address - Country:US
Practice Address - Phone:917-915-1138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty