Provider Demographics
NPI:1447504345
Name:HA, KWANGYI (LAC)
Entity type:Individual
Prefix:
First Name:KWANGYI
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 LIMEKILN PIKE STE 2
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3602
Mailing Address - Country:US
Mailing Address - Phone:215-997-7878
Mailing Address - Fax:215-997-7879
Practice Address - Street 1:3425 LIMEKILN PIKE STE 2
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3602
Practice Address - Country:US
Practice Address - Phone:215-699-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00089500171100000X
PAAK001014171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist