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Organization

EASTERN SUN ACUPUNCTURE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN YONEYAMA LAC (OWNER/ LICENSED ACUPUNCTURIST)
(631) 765-2100
Entity
Organization

Contact information

Practice address
53345 MAIN RD STE 6-1, SOUTHOLD, NY 11971-4643
(631) 765-2100
Mailing address
PO BOX 523, SOUTHOLD, NY 11971-0523
(631) 765-2100

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053705798
LAC
NY
Enumeration date
10/23/2018
Last updated
10/23/2018
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