Provider Demographics
NPI:1699064527
Name:CHA, YOON OK (L AC)
Entity type:Individual
Prefix:MRS
First Name:YOON OK
Middle Name:
Last Name:CHA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2915
Mailing Address - Country:US
Mailing Address - Phone:845-623-4187
Mailing Address - Fax:845-624-3064
Practice Address - Street 1:134 E ROUTE 59
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2915
Practice Address - Country:US
Practice Address - Phone:845-623-4187
Practice Address - Fax:845-624-3064
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000362171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist