Provider Demographics
NPI:1336691641
Name:SUSAN C ENGEL
Entity Type:Organization
Organization Name:SUSAN C ENGEL
Other - Org Name:WHITE CRANE ACUPUNCTURE AND ALLERGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:973-454-8594
Mailing Address - Street 1:275 SUSSEX AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-3120
Mailing Address - Country:US
Mailing Address - Phone:973-454-8594
Mailing Address - Fax:
Practice Address - Street 1:41 ELM ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7201
Practice Address - Country:US
Practice Address - Phone:973-454-8594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00120500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty