Provider Demographics
NPI:1518374370
Name:HAI-CHORON, LIVNAT (LAC)
Entity Type:Individual
Prefix:
First Name:LIVNAT
Middle Name:
Last Name:HAI-CHORON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VALLEY VIEW TER
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1023
Mailing Address - Country:US
Mailing Address - Phone:201-655-9501
Mailing Address - Fax:
Practice Address - Street 1:54 AMES AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1702
Practice Address - Country:US
Practice Address - Phone:201-636-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00106500171100000X
NY25005142171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist