Provider Demographics
NPI:1083050363
Name:PUREME ACUPUNCTURE WELLNESS CENTER
Entity Type:Organization
Organization Name:PUREME ACUPUNCTURE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:BYUNG MOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-497-8880
Mailing Address - Street 1:99 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-497-8880
Mailing Address - Fax:201-497-8881
Practice Address - Street 1:99 KINDERKAMACK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-497-8880
Practice Address - Fax:201-497-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00070100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty