Provider Demographics
NPI:1649669870
Name:LEE, JOO YUN (LAC, LMT)
Entity type:Individual
Prefix:
First Name:JOO YUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-2034
Mailing Address - Country:US
Mailing Address - Phone:516-755-5855
Mailing Address - Fax:
Practice Address - Street 1:34 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2034
Practice Address - Country:US
Practice Address - Phone:516-755-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033267225700000X
NY005477-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist