Provider Demographics
NPI:1710007265
Name:BLUE SKY ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:BLUE SKY ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:CHI-SHEN
Authorized Official - Last Name:SUNG
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:718-733-1000
Mailing Address - Street 1:2676 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-4914
Mailing Address - Country:US
Mailing Address - Phone:718-733-1000
Mailing Address - Fax:718-733-0351
Practice Address - Street 1:2676 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-4914
Practice Address - Country:US
Practice Address - Phone:718-733-1000
Practice Address - Fax:718-733-0351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002074171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty