Provider Demographics
NPI:1982389425
Name:KWEON, HYOUK-EUN CAROLYN (L AC)
Entity Type:Individual
Prefix:
First Name:HYOUK-EUN
Middle Name:CAROLYN
Last Name:KWEON
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:H
Other - Last Name:KWEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC
Mailing Address - Street 1:50 FARRELL CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2085
Mailing Address - Country:US
Mailing Address - Phone:718-344-4572
Mailing Address - Fax:
Practice Address - Street 1:181 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-6446
Practice Address - Country:US
Practice Address - Phone:862-252-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007230171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist