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General NPI Number Information
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NPI Number | 1528534625
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Entity Type | Organization
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Legal Business Name | JERSEY SHORE ACUPUNCTURE
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | JERSEY SHORE ACUPUNCTURE 1000 SANGER AVE STE #205
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City | OCEANPORT
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State | NJ
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Zip | 07757-0775
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Country | US
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Telephone | 732-996-3659
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Fax | 732-475-4875
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Provider Business Mailing Address
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Address Line | 1000 SANGER AVE STE 205
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City | OCEANPORT
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State | NJ
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Zip | 07757-1241
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Country | US
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Telephone | 732-996-3659
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Fax |
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Authorized Official
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Title or Position | OFFICE ASSISTANT
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Name | MS. KATHLEEN KEENAN
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Credential |
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Telephone | 732-996-3659
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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 |
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License Number State |
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