Jung Tak Kim, | |
4124 161st St Apt 2a2, Flushing, NY 11358-4137 | |
(646) 353-7260 | |
Not Available |
Full Name | Jung Tak Kim |
---|---|
Gender | Male |
Speciality | Acupuncturist |
Location | 4124 161st St Apt 2a2, Flushing, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114697307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | 006405 (New York) | Primary |
Provider Name | Sonic Rehab Pt Pllc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1013573914 PECOS PAC ID: 6002239019 Enrollment ID: O20200922000528 |
Mailing Address | Practice Location Address |
---|---|
Jung Tak Kim, 4124 161st St Apt 2a2, Flushing, NY 11358-4137 Ph: (646) 353-7260 | Jung Tak Kim, 4124 161st St Apt 2a2, Flushing, NY 11358-4137 Ph: (646) 353-7260 |
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Dr. Cho Duen Ho, L.AC Acupuncturist Medicare: Not Enrolled in Medicare Practice Location: 4183 Frame Pl, Flushing, NY 11355 Phone: 718-762-7205 |