Provider Demographics
NPI:1558184507
Name:JAESUN YOO ACUPUNCTURE PC
Entity type:Organization
Organization Name:JAESUN YOO ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JAESUN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:914-421-1001
Mailing Address - Street 1:450 MAMARONECK AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2430
Mailing Address - Country:US
Mailing Address - Phone:914-421-1001
Mailing Address - Fax:914-421-1001
Practice Address - Street 1:450 MAMARONECK AVE STE 414
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2430
Practice Address - Country:US
Practice Address - Phone:914-421-1001
Practice Address - Fax:914-421-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty