Provider Demographics
NPI:1821305764
Name:HAN, CHUL-HAK (LAC/PHD)
Entity Type:Individual
Prefix:MR
First Name:CHUL-HAK
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:LAC/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 FARMINGTON AVENUE #201
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-502-9462
Mailing Address - Fax:860-838-6806
Practice Address - Street 1:641 FARMINGTON AVENUE #201
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-502-9462
Practice Address - Fax:860-838-6806
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208303176171100000X
CT000488171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist