Healthcare Provider Details

I. General information

NPI: 1518896166
Provider Name (Legal Business Name): HEALTH LIFE ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PARK ST STE 1
HARRINGTON PARK NJ
07640-1933
US

IV. Provider business mailing address

11 PARK ST STE 1
HARRINGTON PARK NJ
07640-1933
US

V. Phone/Fax

Practice location:
  • Phone: 201-904-6929
  • Fax:
Mailing address:
  • Phone: 201-693-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HWALLAN KIM
Title or Position: OWNER
Credential:
Phone: 201-904-6929