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NPI 1114574381

NPI 1114574381 : WELLNESS IN BERGEN INC : ENGLEWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1114574381
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    Entity Type          |    Organization 
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    Legal Business Name  |    WELLNESS IN BERGEN INC 
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Dates
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    Enumeration Date     |    08/22/2019
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    Last Update Date     |    08/22/2019
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Provider Practice Location Address
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    Address Line         |    40 N VAN BRUNT ST # 29A 
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    City                 |    ENGLEWOOD
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    State                |    NJ
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    Zip                  |    07631-2740
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    Country              |    US
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    Telephone            |    201-431-5066
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    40 N VAN BRUNT ST # 29A 
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    City                 |    ENGLEWOOD
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    State                |    NJ
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    Zip                  |    07631-2740
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    Country              |    US
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    Telephone            |    201-431-5066
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     EVELYN  CHEN 
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    Credential           |    
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    Telephone            |    201-431-5066
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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       |    
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    License Number State |    
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