Provider Demographics
NPI:1407325665
Name:EMMANUEL ACUPUNCTURE
Entity Type:Organization
Organization Name:EMMANUEL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REP
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-789-3227
Mailing Address - Street 1:1634 PONSI ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6319
Mailing Address - Country:US
Mailing Address - Phone:201-292-1590
Mailing Address - Fax:201-584-0303
Practice Address - Street 1:1634 PONSI ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6319
Practice Address - Country:US
Practice Address - Phone:917-648-6661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-17
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty