Healthcare Provider Details

I. General information

NPI: 1811453657
Provider Name (Legal Business Name): YIMIN ACUPUNCTURE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 GLEN AVE
ROSELAND NJ
07068-1631
US

IV. Provider business mailing address

26 GLEN AVE
ROSELAND NJ
07068-1631
US

V. Phone/Fax

Practice location:
  • Phone: 862-220-5590
  • Fax:
Mailing address:
  • Phone: 862-220-5590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LAUREN KUCHNO
Title or Position: OFFICE REP
Credential:
Phone: 833-789-3227