Healthcare Provider Details

I. General information

NPI: 1720243405
Provider Name (Legal Business Name): NI-FEI HSIEH MSTOM, L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E HANOVER AVE UNIT 1
MORRISTOWN NJ
07960-4073
US

IV. Provider business mailing address

35 STOCKTON CT
MORRIS PLAINS NJ
07950-1293
US

V. Phone/Fax

Practice location:
  • Phone: 973-998-8433
  • Fax: 973-528-9803
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number26BT00338400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number023451
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00063200
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number003828
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: