Healthcare Provider Details

I. General information

NPI: 1457699480
Provider Name (Legal Business Name): TAO CLINIC OF ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 ROUTE 73 N STE 200
MARLTON NJ
08053-1227
US

IV. Provider business mailing address

999 ROUTE 73 N STE 200
MARLTON NJ
08053-1227
US

V. Phone/Fax

Practice location:
  • Phone: 856-802-6888
  • Fax: 856-802-6878
Mailing address:
  • Phone: 856-802-6888
  • Fax: 856-802-6878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAN MIAO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 267-721-2288