Provider Demographics
NPI:1356777387
Name:SHIN, YUNAH (MS, LAC)
Entity type:Individual
Prefix:
First Name:YUNAH
Middle Name:
Last Name:SHIN
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 BELL BLVD
Mailing Address - Street 2:#105
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2000
Mailing Address - Country:US
Mailing Address - Phone:347-757-0646
Mailing Address - Fax:
Practice Address - Street 1:2391 BELL BLVD
Practice Address - Street 2:#105
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2000
Practice Address - Country:US
Practice Address - Phone:347-757-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005105171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist