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General NPI Number Information
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NPI Number | 1053768598
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Entity Type | Organization
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Legal Business Name | KE JIN'S ACUPUNCTURE & HERBAL CLINIC
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Dates
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Enumeration Date | 05/14/2016
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Last Update Date | 12/10/2016
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Provider Practice Location Address
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Address Line | 1187 MAIN AVE SUITE 1C
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City | CLIFTON
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State | NJ
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Zip | 07011-2252
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Country | US
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Telephone | 732-823-7219
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Fax |
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Provider Business Mailing Address
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Address Line | 275 E MOUNT PLEASANT AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3210
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Country | US
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Telephone | 732-823-7219
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Fax |
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Authorized Official
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Title or Position | LAC
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Name | KE JIN
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Credential | LAC
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Telephone | 732-823-7219
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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 | 25MZ00071100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00110700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00104000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00108600
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00106400
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00122100
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License Number State | NJ
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