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General NPI Number Information
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NPI Number | 1407123029
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Entity Type | Organization
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Legal Business Name | RIVER DELL ACUPUNCTURE WELLNESS PC
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 56 GATES AVE
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City | RIVER EDGE
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State | NJ
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Zip | 07661-2402
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Country | US
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Telephone | 201-993-6115
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Fax | 201-483-6295
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Provider Business Mailing Address
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Address Line | 56 GATES AVE
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City | RIVER EDGE
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State | NJ
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Zip | 07661-2402
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Country | US
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Telephone | 201-993-6115
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Fax | 201-483-6295
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. ESTHER M. XIA
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Credential | L. AC.
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Telephone | 201-993-6115
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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 | 25MZ00014600
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License Number State | NJ
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