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General NPI Number Information
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NPI Number | 1669637377
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Entity Type | Organization
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Legal Business Name | CLINICA DE ACUPUNTURA Y SALUD
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 6135 BERGENLINE AVE #3
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-1562
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Country | US
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Telephone | 201-854-8488
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Fax | 201-854-8964
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Provider Business Mailing Address
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Address Line | 6135 BERGENLINE AVE #3
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-1562
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Country | US
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Telephone | 201-854-8488
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Fax | 201-854-8964
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAE Y HONG
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Credential | D.C
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Telephone | 201-854-8488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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