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General NPI Number Information
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NPI Number | 1447524780
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Entity Type | Organization
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Legal Business Name | ORANGE ACUPUNCTURE
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 439 MAIN ST #101-B
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City | ORANGE
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State | NJ
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Zip | 07050-1523
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Country | US
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Telephone | 973-677-0954
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Fax | 973-677-9868
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Provider Business Mailing Address
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Address Line | 439 MAIN ST #101-B
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City | ORANGE
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State | NJ
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Zip | 07050-1523
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Country | US
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Telephone |
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Fax | 973-677-9868
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Authorized Official
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Title or Position | PRESIDENT
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Name | JI KIM
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Credential |
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Telephone | 973-677-0954
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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 | 25MZ00045000
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License Number State | NJ
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