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General NPI Number Information
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NPI Number | 1679629562
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Entity Type | Organization
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Legal Business Name | CENTER FOR ACUPUNCTURE AND HERBAL MEDICINE, P.A.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 166 MOUNTAIN AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3131
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Country | US
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Telephone | 908-654-4333
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Fax | 908-654-4633
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Provider Business Mailing Address
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Address Line | 166 MOUNTAIN AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3131
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Country | US
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Telephone | 908-654-4333
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Fax | 908-654-4633
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Authorized Official
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Title or Position | PRESIDENT, ACUPUNCTURIST, HERBALIST
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Name | ROSS ROSEN
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Credential | JD, MSTOM, LAC, CA,
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Telephone | 908-654-4333
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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 | NJ25MZ000020500
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License Number State | NJ
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