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General NPI Number Information
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NPI Number | 1790508463
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Entity Type | Organization
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Legal Business Name | DAEYON THERATOPIA ACUPUNCTURE LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 2500 LEMOINE AVE STE 303
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City | FORT LEE
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State | NJ
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Zip | 07024-6243
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Country | US
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Telephone | 646-300-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 LEMOINE AVE STE 303
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City | FORT LEE
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State | NJ
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Zip | 07024-6243
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Country | US
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Telephone | 646-300-5990
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MIKYUNG LEE
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Credential |
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Telephone | 646-300-5990
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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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