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General NPI Number Information
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NPI Number | 1518216456
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Entity Type | Organization
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Legal Business Name | RIVERVIEW ACU LLC
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 725 RIVER RD SUITE #102
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City | EDGEWATER
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State | NJ
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Zip | 07020
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Country | US
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Telephone | 201-943-7768
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Fax | 201-943-7798
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Provider Business Mailing Address
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Address Line | 725 RIVER RD SUITE #102
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City | EDGEWATER
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State | NJ
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Zip | 07020
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Country | US
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Telephone | 201-943-7768
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Fax | 201-943-7798
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Authorized Official
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Title or Position | PRESIDENT/ACUPUNCTURIST
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Name | DR. EUGENE LEE
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Credential | L.AC.
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Telephone | 201-943-7768
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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 | 25MZ00048000
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License Number State | NJ
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