Healthcare Provider Details

I. General information

NPI: 1295543601
Provider Name (Legal Business Name): PRISTINE HEALTH ACUPUNCTURE AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 CLINTON PL APT 404
HACKENSACK NJ
07601-4664
US

IV. Provider business mailing address

131 CLINTON PL APT 404
HACKENSACK NJ
07601-4664
US

V. Phone/Fax

Practice location:
  • Phone: 201-669-8823
  • Fax:
Mailing address:
  • Phone: 201-669-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE YUN
Title or Position: ACUPUNCTURIST
Credential:
Phone: 201-669-8823