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General NPI Number Information
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NPI Number | 1932452919
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Entity Type | Organization
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Legal Business Name | SASHA ACUPUNCTURE AND HERBAL MEDICINE LLC
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 70 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-5907
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Country | US
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Telephone | 862-703-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 44 TREMONT PL
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City | MONTCLAIR
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State | NJ
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Zip | 07042-5040
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Country | US
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Telephone | 862-703-0966
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALEKSANDRA MIHAJLOVIC
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Credential | L.AC.
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Telephone | 862-703-0966
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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 | 25MZ00093700
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License Number State | NJ
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