Individual provider Active NPI

Soo C. Oh, L. AC.

  • Acupuncturist
  • Bayside, NY
National Provider Identifier
1225275522
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
001751 Issued in NY
Practice address
4514 Springfield Blvd
Bayside, NY 11361-3556
Phone
(718) 225-5651
Fax
(718) 225-5651
NPI assigned
Jan 8, 2009
Last updated
Jan 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 001751 NY Primary

Addresses

Primary practice location

4514 Springfield Blvd
Bayside, NY 11361-3556

Mailing address

4514 Springfield Blvd
Bayside, NY 11361-3556
Phone (718) 225-5651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001751NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1225275522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613556",
            "telephone_number": "718-225-5651",
            "fax_number": "718-225-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613556",
            "telephone_number": "718-225-5651",
            "fax_number": "718-225-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "SOO",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "L. AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "001751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.