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General NPI Number Information
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NPI Number | 1275877730
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Entity Type | Organization
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Legal Business Name | JC OLD STONE ACUPUNCTURE, P.C.
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 3285 JOHN F KENNEDY BLVD LOWER LEVEL
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City | JERSEY CITY
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State | NJ
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Zip | 07307-4228
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Country | US
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Telephone | 516-319-5859
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11168
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08906-1168
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Country | US
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Telephone | 516-319-5859
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Fax |
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Authorized Official
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Title or Position | OMD
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Name | GEXIN CHEN
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Credential | L.AC.
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Telephone | 516-319-5859
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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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