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General NPI Number Information
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NPI Number | 1598251472
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Entity Type | Individual
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Provider Name | JEONG EUN LEE ACUPUNCTURIST
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Gender | Female
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 26 CARTER ST
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City | NORWOOD
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State | NJ
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Zip | 07648-1518
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Country | US
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Telephone | 201-290-9339
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Fax |
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Provider Business Mailing Address
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Address Line | 172 FRANKLIN AVE STE 3A
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3228
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Country | US
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Telephone | 201-556-8770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 006127
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00132100
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License Number State | NJ
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