Provider Demographics
NPI:1093969925
Name:JIN, CHRISTI (PHD, OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTI
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:PHD, OMD, LAC
Other - Prefix:
Other - First Name:CHUNYU
Other - Middle Name:
Other - Last Name:JIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:344 THE PROMENADE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-2122
Mailing Address - Country:US
Mailing Address - Phone:201-952-0063
Mailing Address - Fax:
Practice Address - Street 1:444 MARKET ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5996
Practice Address - Country:US
Practice Address - Phone:201-952-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003670171100000X
NJ25MZ00060500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist