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Individual

KEUN AE PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
21406 18TH AVE, BAYSIDE, NY 11360-1636
(718) 819-8728
Mailing address
21406 18TH AVE, BAYSIDE, NY 11360-1636
(718) 819-8728

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006109
NY

Other

Enumeration date
08/29/2018
Last updated
08/29/2018
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