Provider Demographics
NPI:1215285549
Name:PYO, KYOUNGYI (LAC)
Entity type:Individual
Prefix:MRS
First Name:KYOUNGYI
Middle Name:
Last Name:PYO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 W 32ND ST STE 1612
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3874
Mailing Address - Country:US
Mailing Address - Phone:212-564-5953
Mailing Address - Fax:
Practice Address - Street 1:38 W 32ND ST STE 1612
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3874
Practice Address - Country:US
Practice Address - Phone:212-564-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004469171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist