Provider Demographics
NPI:1033503370
Name:HA, JOOUN (DC, LAC)
Entity Type:Individual
Prefix:
First Name:JOOUN
Middle Name:
Last Name:HA
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SYLVAN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2717
Mailing Address - Country:US
Mailing Address - Phone:201-408-4068
Mailing Address - Fax:201-408-5558
Practice Address - Street 1:400 SYLVAN AVE STE 210
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2717
Practice Address - Country:US
Practice Address - Phone:201-408-4068
Practice Address - Fax:201-408-5558
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012568-1111N00000X
NJ25MZ00087400171100000X
NY005832-1171100000X
NJ38MC00698400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist