Provider Demographics
NPI:1255844569
Name:LOHAS ACUPUNCTURE AND HERBS LLC
Entity Type:Organization
Organization Name:LOHAS ACUPUNCTURE AND HERBS LLC
Other - Org Name:LOHAS ACUPUNCTURE AND HERBS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER, LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JIYUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-815-7070
Mailing Address - Street 1:1579 PALISADE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6931
Mailing Address - Country:US
Mailing Address - Phone:201-815-7070
Mailing Address - Fax:201-585-7070
Practice Address - Street 1:1579 PALISADE AVE FL 2
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6931
Practice Address - Country:US
Practice Address - Phone:201-815-7070
Practice Address - Fax:201-585-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00098300171100000X
NY005031171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1750624128OtherACUPUNCTURE