Provider Demographics
NPI:1154650356
Name:SUN, JENNIFER J (LAC)
Entity Type:Individual
Prefix:PROF
First Name:JENNIFER
Middle Name:J
Last Name:SUN
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:190 STATE ROUTE 18 N STE 200
Mailing Address - Street 2:TURNPIKE METROPLEX
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1407
Mailing Address - Country:US
Mailing Address - Phone:732-822-9801
Mailing Address - Fax:732-509-9196
Practice Address - Street 1:190 STATE ROUTE 18 N STE 200
Practice Address - Street 2:190 STATE ROUTE 18N, SUITE 200
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1407
Practice Address - Country:US
Practice Address - Phone:732-822-9801
Practice Address - Fax:732-509-9196
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00071300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist