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General NPI Number Information
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NPI Number | 1578129490
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Entity Type | Organization
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Legal Business Name | BEAUTE MEDISPA, LLC
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 195 ROUTE 9 STE 101
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City | MANALAPAN
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State | NJ
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Zip | 07726-8294
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Country | US
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Telephone | 917-270-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CURTINS COR
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City | MILLSTONE TOWNSHIP
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State | NJ
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Zip | 08510-1237
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Country | US
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Telephone | 917-270-8643
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JEFFREY MARK LIN
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Credential | MD
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Telephone | 917-270-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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