Provider Demographics
NPI:1164898938
Name:HAN ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:HAN ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SEUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-840-5412
Mailing Address - Street 1:845 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1002
Mailing Address - Country:US
Mailing Address - Phone:201-840-5412
Mailing Address - Fax:
Practice Address - Street 1:845 BROAD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1002
Practice Address - Country:US
Practice Address - Phone:201-840-5412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00113300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty