=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578361788
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN ARCEGA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2025
-----------------------------------------------------
Last Update Date | 03/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1122 US HIGHWAY 22
-----------------------------------------------------
City | MOUNTAINSIDE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07092-2812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-540-6198
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22 NORTH AVE
-----------------------------------------------------
City | GARWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07027-1138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-744-1603
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 25MZ00174400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------