Provider Demographics
NPI:1073839353
Name:YANG, HAIZHEN H (LAC)
Entity Type:Individual
Prefix:MS
First Name:HAIZHEN
Middle Name:H
Last Name:YANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:191 WOODPORT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2641
Mailing Address - Country:US
Mailing Address - Phone:973-512-8493
Mailing Address - Fax:
Practice Address - Street 1:191 WOODPORT RD STE 202
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2641
Practice Address - Country:US
Practice Address - Phone:973-512-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004310171100000X
NJ25MZ00083000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist