Provider Demographics
NPI:1396071098
Name:UNSOOK PARK'S ACUPUNCTURE P.C
Entity type:Organization
Organization Name:UNSOOK PARK'S ACUPUNCTURE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:UNSOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-442-4077
Mailing Address - Street 1:2001 MARCUS AVE
Mailing Address - Street 2:SUITE 95W
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2061
Mailing Address - Country:US
Mailing Address - Phone:516-442-4077
Mailing Address - Fax:
Practice Address - Street 1:46-17 215TH PLACE
Practice Address - Street 2:APT 1B
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361
Practice Address - Country:US
Practice Address - Phone:516-442-4077
Practice Address - Fax:516-442-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002152171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty