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General NPI Number Information
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NPI Number | 1154955912
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Entity Type | Organization
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Legal Business Name | TRADITIONAL CHINESE ACUPUNCTURE AND WELLNESS CENTER
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 575 NEW JERSEY-28 BUILDING ONE SUITE 204B
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City | RARITAIN
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State | NJ
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Zip | 08869
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Country | US
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Telephone | 201-281-7051
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Fax |
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Provider Business Mailing Address
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Address Line | 575 NEW JERSEY-28 BUILDING ONE SUITE 204B
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City | RARITAIN
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State | NJ
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Zip | 08869
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Country | US
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Telephone | 201-281-7051
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Fax |
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Authorized Official
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Title or Position | OFFICE REP
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Name | LAUREN KUCHNO
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Credential |
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Telephone | 833-789-3227
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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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