Healthcare Provider Details

I. General information

NPI: 1962705640
Provider Name (Legal Business Name): YEE ACUPUNCTURE AND HERBS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 CENTRAL AVE STE 302
EAST ORANGE NJ
07018-1943
US

IV. Provider business mailing address

45 BROAD AVE
PALISADES PARK NJ
07650-1443
US

V. Phone/Fax

Practice location:
  • Phone: 201-313-0501
  • Fax: 201-313-1454
Mailing address:
  • Phone: 201-313-0501
  • Fax: 201-313-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00019800
License Number StateNJ

VIII. Authorized Official

Name: MR. SUNG JAE HONG
Title or Position: PRESIDENT
Credential: LAC
Phone: 201-313-0501