Healthcare Provider Details

I. General information

NPI: 1447162821
Provider Name (Legal Business Name): HEEJUN JAMES LEE L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ST ANDREWS CIR
RIVER VALE NJ
07675-6522
US

IV. Provider business mailing address

7 ST ANDREWS CIR
RIVER VALE NJ
07675-6522
US

V. Phone/Fax

Practice location:
  • Phone: 201-995-4779
  • Fax:
Mailing address:
  • Phone: 201-995-4779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00184400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: