Healthcare Provider Details

I. General information

NPI: 1144132804
Provider Name (Legal Business Name): LY BRIDGE ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 BIGLER ST UNIT A
FORT LEE NJ
07024-7300
US

IV. Provider business mailing address

2000 BIGLER ST UNIT A
FORT LEE NJ
07024-7300
US

V. Phone/Fax

Practice location:
  • Phone: 201-777-4439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LANG YOO
Title or Position: OWNER
Credential: L.AC.
Phone: 201-777-4439