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General NPI Number Information
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NPI Number | 1366768327
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Entity Type | Organization
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Legal Business Name | SHINBI ACUPUNCTURE CARE, P.C.
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 535 N 7TH ST FL 1
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City | NEWARK
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State | NJ
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Zip | 07107-2423
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Country | US
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Telephone | 973-412-1900
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Fax | 973-412-1944
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Provider Business Mailing Address
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Address Line | 464 HUDSON TER STE 204
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2917
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Country | US
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Telephone | 201-894-5451
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Fax | 201-894-5450
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAEGYUN KIM
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Credential | L. AC.
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Telephone | 201-894-5451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MZ00040500
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License Number State | NJ
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