Individual
MRS. SOON R. PAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., R.N.
Contact information
Practice address
20105 NORTHERN BLVD, BAYSIDE, NY 11361-2563
(718) 423-8046
(718) 423-4907
Mailing address
20105 NORTHERN BLVD, BAYSIDE, NY 11361-2563
(718) 423-8046
(718) 423-4907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
390528
NY
171100000X
Acupuncturist
Primary
002792
NY
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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