Provider Demographics
NPI:1669171104
Name:YOUNG PARK ACUPUNCTURE PC
Entity type:Organization
Organization Name:YOUNG PARK ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-637-4780
Mailing Address - Street 1:20 BRUCE LN
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-4502
Mailing Address - Country:US
Mailing Address - Phone:718-637-4780
Mailing Address - Fax:
Practice Address - Street 1:37 CONGERS RD FL 1
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5135
Practice Address - Country:US
Practice Address - Phone:718-637-4780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty