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General NPI Number Information
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NPI Number | 1013200393
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Entity Type | Organization
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Legal Business Name | PRIME ACUPUNCTURE LLC
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 43 W PROSPECT ST STE 203
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2184
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Country | US
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Telephone | 848-210-5891
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Fax |
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Provider Business Mailing Address
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Address Line | 103 TICES LN
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2029
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | HUI YANG
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Credential |
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Telephone | 848-210-5891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00042400
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License Number State | NJ
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