Provider Demographics
NPI:1275877730
Name:JC OLD STONE ACUPUNCTURE, P.C.
Entity Type:Organization
Organization Name:JC OLD STONE ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OMD
Authorized Official - Prefix:
Authorized Official - First Name:GEXIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:516-319-5859
Mailing Address - Street 1:PO BOX 11168
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08906-1168
Mailing Address - Country:US
Mailing Address - Phone:516-319-5859
Mailing Address - Fax:
Practice Address - Street 1:3285 JOHN F KENNEDY BLVD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4228
Practice Address - Country:US
Practice Address - Phone:516-319-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty