Provider Demographics
NPI:1528577244
Name:WENJING ACUPUNCTURE AND HERB LLC
Entity Type:Organization
Organization Name:WENJING ACUPUNCTURE AND HERB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENJING
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-208-7409
Mailing Address - Street 1:746 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-4446
Mailing Address - Country:US
Mailing Address - Phone:347-510-6297
Mailing Address - Fax:
Practice Address - Street 1:746 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-4446
Practice Address - Country:US
Practice Address - Phone:347-510-6297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00111800171100000X
NY004757171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty