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General NPI Number Information
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NPI Number | 1194416040
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Entity Type | Organization
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Legal Business Name | ON ACUPUNCTURE
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 277 CLOSTER DOCK RD STE 1
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City | CLOSTER
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State | NJ
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Zip | 07624-2445
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Country | US
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Telephone | 201-637-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 277 CLOSTER DOCK RD STE 1
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City | CLOSTER
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State | NJ
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Zip | 07624-2445
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Country | US
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Telephone | 201-637-0355
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL PARK
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Credential | DATM
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Telephone | 201-315-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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