Provider Demographics
NPI:1871304709
Name:SUN, JUNCAN
Entity type:Individual
Prefix:MR
First Name:JUNCAN
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BROAD AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:PALISADES PK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1479
Mailing Address - Country:US
Mailing Address - Phone:201-233-4276
Mailing Address - Fax:
Practice Address - Street 1:100 ROUTE 303
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2117
Practice Address - Country:US
Practice Address - Phone:845-680-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007618171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist