Provider Demographics
NPI:1386140812
Name:HAN ACUPUNCTURE
Entity type:Organization
Organization Name:HAN ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYONG SU
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:201-240-2488
Mailing Address - Street 1:2449B ROSSETT ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3919
Mailing Address - Country:US
Mailing Address - Phone:201-240-2488
Mailing Address - Fax:
Practice Address - Street 1:100 ROUTE 303 STE 1
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2117
Practice Address - Country:US
Practice Address - Phone:845-680-6294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006038171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty