Provider Demographics
NPI:1063211548
Name:JUNG, WOOCHUL (LAC)
Entity type:Individual
Prefix:
First Name:WOOCHUL
Middle Name:
Last Name:JUNG
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 195TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3024
Mailing Address - Country:US
Mailing Address - Phone:347-952-0708
Mailing Address - Fax:
Practice Address - Street 1:4026 195TH ST FL 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3024
Practice Address - Country:US
Practice Address - Phone:347-952-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007643-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist