Provider Demographics
NPI:1336332147
Name:SHENNONG USA, INC.
Entity Type:Organization
Organization Name:SHENNONG USA, INC.
Other - Org Name:SHENNONG ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DING
Authorized Official - Middle Name:
Authorized Official - Last Name:GU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:215-380-9744
Mailing Address - Street 1:10 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2588
Mailing Address - Country:US
Mailing Address - Phone:215-380-9744
Mailing Address - Fax:
Practice Address - Street 1:2229-D MACDADE BLVD.
Practice Address - Street 2:
Practice Address - City:HOLMES
Practice Address - State:PA
Practice Address - Zip Code:19043
Practice Address - Country:US
Practice Address - Phone:610-532-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000279L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty