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General NPI Number Information
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NPI Number | 1740087303
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Entity Type | Organization
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Legal Business Name | SPORTSMED ACUPUNTURE OF NEW JERSEY, LLC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 266 HARRISTOWN RD STE 200
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City | GLEN ROCK
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State | NJ
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Zip | 07452-3354
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Country | US
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Telephone | 201-445-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 266 HARRISTOWN RD STE 304
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City | GLEN ROCK
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State | NJ
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Zip | 07452-3321
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Country | US
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Telephone | 973-767-2880
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Fax |
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Authorized Official
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Title or Position | VP, RCM
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Name | CAROL AZAR
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Credential |
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Telephone | 201-857-0527
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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 |
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License Number State |
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