Provider Demographics
NPI:1407354194
Name:OH, JAMES J (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:OH
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 204TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2625
Mailing Address - Country:US
Mailing Address - Phone:917-697-3133
Mailing Address - Fax:
Practice Address - Street 1:4014 BOSTON RD # A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1120
Practice Address - Country:US
Practice Address - Phone:917-697-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-27
Last Update Date:2018-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006042171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist