Provider Demographics
NPI:1124346192
Name:FOUR SEASONS ACUPUNCTURE, P.C.
Entity type:Organization
Organization Name:FOUR SEASONS ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANGWON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-642-2908
Mailing Address - Street 1:14 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5215
Mailing Address - Country:US
Mailing Address - Phone:646-642-2908
Mailing Address - Fax:
Practice Address - Street 1:27 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2429
Practice Address - Country:US
Practice Address - Phone:516-489-2626
Practice Address - Fax:877-719-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty