Healthcare Provider Details

I. General information

NPI: 1669892444
Provider Name (Legal Business Name): ACU WELL OF AMERICA , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 LAKE ST
RAMSEY NJ
07446-2089
US

IV. Provider business mailing address

171 LAKE ST
RAMSEY NJ
07446-2089
US

V. Phone/Fax

Practice location:
  • Phone: 201-327-1990
  • Fax: 201-327-1921
Mailing address:
  • Phone: 201-327-1990
  • Fax: 201-327-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00070600
License Number StateNJ

VIII. Authorized Official

Name: EVAN M CHAIT
Title or Position: ACUPUNCTURIST
Credential:
Phone: 201-327-1990