Provider Demographics
NPI:1972728152
Name:CHOI, KYUNG (LAC)
Entity Type:Individual
Prefix:
First Name:KYUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8243 JERICHO TPKE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1887
Mailing Address - Country:US
Mailing Address - Phone:631-271-2440
Mailing Address - Fax:
Practice Address - Street 1:8243 JERICHO TPKE
Practice Address - Street 2:SUITE 240
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1887
Practice Address - Country:US
Practice Address - Phone:631-271-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25002636171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist