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General NPI Number Information
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NPI Number | 1124531710
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Entity Type | Individual
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Provider Name | JEONGHAN LIM
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Gender | Male
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 65 E NORTHFIELD RD STE D1L
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City | LIVINGSTON
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State | NJ
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Zip | 07039-4525
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Country | US
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Telephone | 862-370-9202
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Fax |
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Provider Business Mailing Address
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Address Line | 69 OVAL RD
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City | MILLBURN
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State | NJ
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Zip | 07041-1409
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Country | US
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Telephone | 215-316-4315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 006037
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License Number State | NY
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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 | 0121000852
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License Number State | VA
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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 | 25MN00128000
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License Number State | NJ
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