Provider Demographics
NPI:1669799623
Name:KANGSUN ACUPUNCTURE & HERB PLLC
Entity type:Organization
Organization Name:KANGSUN ACUPUNCTURE & HERB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAC
Authorized Official - Prefix:
Authorized Official - First Name:SON
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-693-8818
Mailing Address - Street 1:1239 POST RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-2132
Mailing Address - Country:US
Mailing Address - Phone:917-693-8818
Mailing Address - Fax:718-866-0163
Practice Address - Street 1:2604 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1199
Practice Address - Country:US
Practice Address - Phone:718-866-0153
Practice Address - Fax:718-866-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003016171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty