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General NPI Number Information
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NPI Number | 1487914933
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Entity Type | Organization
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Legal Business Name | ONCARE ACUPUNCTURE & HERB, PC
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 266 VAN BUREN ST
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City | NEWARK
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State | NJ
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Zip | 07105-2514
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Country | US
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Telephone | 201-621-3439
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Fax |
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Provider Business Mailing Address
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Address Line | 240 BROAD AVE
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1509
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Country | US
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Telephone | 201-621-3439
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUSTIN Y KANG
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Credential | L.AC.
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Telephone | 201-621-3439
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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 | 25MZ00089800
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License Number State | NJ
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