Provider Demographics
NPI:1235663246
Name:DAWA ACUPUNCTURE
Entity Type:Organization
Organization Name:DAWA ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-585-0972
Mailing Address - Street 1:1580 LEMOINE AVE
Mailing Address - Street 2:SUITE #9
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5621
Mailing Address - Country:US
Mailing Address - Phone:201-585-0972
Mailing Address - Fax:
Practice Address - Street 1:1580 LEMOINE AVE
Practice Address - Street 2:SUITE #9
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5621
Practice Address - Country:US
Practice Address - Phone:201-585-0972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00067100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty