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General NPI Number Information
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NPI Number | 1851650337
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AND ORIENTAL MEDICINE TREATMENT CENTER
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 610 FRANKLIN AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-1244
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Country | US
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Telephone | 973-320-5120
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Fax |
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Provider Business Mailing Address
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Address Line | 610 FRANKLIN AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-1244
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Country | US
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Telephone | 973-320-5120
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MS. LILY PUGLIESE
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Credential | L.AC.
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Telephone | 973-320-5120
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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 | 25MZ00065900
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License Number State | NJ
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