MEDICARE: HAN HOLISTIC CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1912537101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAN HOLISTIC CLINIC INC

Provider Business Mailing Address
First Line	:	140 SYLVAN AVE STE 209
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-2559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 SYLVAN AVE STE 209
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-2559
Country	:	US
Telephone Number	:	201-408-5944
Fax Number	:

Authorized Official
Title or Position	:	ACUPUCNTURIST
Name	:	EUGENE CHOI
Credential	:
Telephone Number	:	201-328-4189

Provider Enumeration Date	:	01/16/2020
Last Update Date	:	12/15/2022

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