Provider Demographics
NPI:1972775757
Name:BON ACUPUNCTURE & HERBS
Entity Type:Organization
Organization Name:BON ACUPUNCTURE & HERBS
Other - Org Name:MIND BODY SKIN ACUPUNCTURE & HERBS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BON YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:OMD, LAC
Authorized Official - Phone:347-284-6778
Mailing Address - Street 1:350 CIRCLE RD
Mailing Address - Street 2:SCHOMBURG B 106A
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3403
Mailing Address - Country:US
Mailing Address - Phone:347-284-6778
Mailing Address - Fax:646-478-9778
Practice Address - Street 1:36 E 38TH ST
Practice Address - Street 2:G/F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2506
Practice Address - Country:US
Practice Address - Phone:347-284-6778
Practice Address - Fax:646-478-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003710171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty