Provider Demographics
NPI:1225339310
Name:TAE ACUPUNCTURE AND HERBS, INC.
Entity Type:Organization
Organization Name:TAE ACUPUNCTURE AND HERBS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-313-0501
Mailing Address - Street 1:65 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624
Mailing Address - Country:US
Mailing Address - Phone:201-313-0501
Mailing Address - Fax:201-313-1454
Practice Address - Street 1:448 BOULEVARD
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604
Practice Address - Country:US
Practice Address - Phone:201-543-4551
Practice Address - Fax:201-313-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00019800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty