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General NPI Number Information
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NPI Number | 1992547319
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Entity Type | Organization
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Legal Business Name | SONG FAMILY ACUPUNCTURE LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 30 KINDERKAMACK RD STE 2
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City | ORADELL
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State | NJ
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Zip | 07649-2664
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Country | US
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Telephone | 201-554-5559
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Fax |
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Provider Business Mailing Address
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Address Line | 30 KINDERKAMACK RD STE 2
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City | ORADELL
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State | NJ
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Zip | 07649-2664
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Country | US
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Telephone | 201-554-5559
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MYUNGSEOK SONG
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Credential | L.AC.
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Telephone | 201-554-5559
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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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