Healthcare Provider Details

I. General information

NPI: 1336925304
Provider Name (Legal Business Name): BALANCE QI ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 MORRIS AVE
ELIZABETH NJ
07208-3609
US

IV. Provider business mailing address

426 MORRIS AVE
ELIZABETH NJ
07208-3609
US

V. Phone/Fax

Practice location:
  • Phone: 212-729-3785
  • Fax:
Mailing address:
  • Phone: 212-729-3785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HYUNGWOOK KIM
Title or Position: PROVIDER
Credential:
Phone: 212-729-3785