Individual
KYONG SU HAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
100 ROUTE 303, TAPPAN, NY 10983-2117
(845) 680-6294
Mailing address
2449B ROSSETT ST, FORT LEE, NJ 07024-3919
(201) 240-2488
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006038-1
NY
225700000X
Massage Therapist
025130-1
NY
Other
Enumeration date
12/14/2017
Last updated
10/06/2021
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