Provider Demographics
NPI:1912418724
Name:THE HEALER'S WAY
Entity Type:Organization
Organization Name:THE HEALER'S WAY
Other - Org Name:THE HEALER'S WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONG
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:917-513-8786
Mailing Address - Street 1:4037 77TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1102
Mailing Address - Country:US
Mailing Address - Phone:917-513-8786
Mailing Address - Fax:
Practice Address - Street 1:16 E 40TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0134
Practice Address - Country:US
Practice Address - Phone:917-513-8786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005741171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty