Individual
IN KUK BANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
20801 NORTHERN BLVD STE 301, BAYSIDE, NY 11361-3118
(718) 224-2250
Mailing address
20801 NORTHERN BLVD STE 301, BAYSIDE, NY 11361-3118
(718) 224-2250
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005930
NY
225700000X
Massage Therapist
027555
NY
Other
Enumeration date
06/05/2017
Last updated
07/21/2022
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