Individual
CHAN JIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
21537 48TH AVE APT 2B, BAYSIDE, NY 11364-1359
(347) 549-2275
Mailing address
21537 48TH AVE APT 2B, BAYSIDE, NY 11364-1359
(347) 549-2275
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
5471
NY
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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