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General NPI Number Information
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NPI Number | 1346362332
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Entity Type | Individual
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Provider Name | TAE-YOUNG J. CHOI L.AC
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 400 SWENSON DR
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City | KENILWORTH
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State | NJ
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Zip | 07033-1323
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Country | US
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Telephone | 908-930-2678
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Fax | 732-482-1731
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Provider Business Mailing Address
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Address Line | 62 CENTRAL AVE
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City | METUCHEN
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State | NJ
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Zip | 08840-1867
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Country | US
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Telephone | 908-930-2678
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Fax | 732-482-1731
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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 | 25MZ00037600
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License Number State | NJ
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