Sung Jae Shin's National Provider Identifier (NPI) Details
Sung Jae Shin, LCSW
NPI: 1710575568
Enumeration Date: 2021-01-07
Last updated: 2024-06-07
Sole Proprietor: NO
Status: active
Postal Address: 6110 ALDERTON ST APT B3, REGO PARK, NY
Phone: 929-206-7720
Primary Practice Address: 7119 165TH ST, FRESH MEADOWS, NY
Practice's phone: 929-206-7720