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General NPI Number Information
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NPI Number | 1083050363
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Entity Type | Organization
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Legal Business Name | PUREME ACUPUNCTURE WELLNESS CENTER
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 99 KINDERKAMACK RD SUITE 302
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City | WESTWOOD
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State | NJ
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Zip | 07675
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Country | US
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Telephone | 201-497-8880
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Fax | 201-497-8881
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Provider Business Mailing Address
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Address Line | 99 KINDERKAMACK RD SUITE 302
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City | WESTWOOD
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State | NJ
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Zip | 07675
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Country | US
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Telephone | 201-497-8880
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Fax | 201-497-8881
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | BYUNG MOON LEE
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Credential | L.AC
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Telephone | 201-497-8880
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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 | 25MZ00070100
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License Number State | NJ
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