Individual provider Active NPI

Min Soo Ji, LAC

  • Acupuncturist
  • Flushing, NY
National Provider Identifier
1912272022
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
004777 Issued in NY
Practice address
3830 Parsons Blvd Ste 1B
Flushing, NY 11354-5843
Phone
(718) 321-0205
Fax
(718) 321-1442
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 004777 NY Primary

Addresses

Primary practice location

3830 Parsons Blvd Ste 1B
Flushing, NY 11354-5843

Mailing address

540 115TH St Apt C
College Point, NY 11356-1059
Phone (347) 882-7805

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

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1912272022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 115TH ST APT C",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113561059",
            "telephone_number": "347-882-7805",
            "fax_number": "718-321-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 PARSONS BLVD STE 1B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545843",
            "telephone_number": "718-321-0205",
            "fax_number": "718-321-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "MIN",
        "middle_name": "SOO",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.