Provider Demographics
NPI:1558774778
Name:PRIME ACUPUNCTURE CARE PC
Entity Type:Organization
Organization Name:PRIME ACUPUNCTURE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MISUK
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-446-6701
Mailing Address - Street 1:118 BROAD AVE
Mailing Address - Street 2:SUITE N10
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2717
Mailing Address - Country:US
Mailing Address - Phone:201-313-1122
Mailing Address - Fax:201-941-1157
Practice Address - Street 1:118 BROAD AVE
Practice Address - Street 2:SUITE N10
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-2717
Practice Address - Country:US
Practice Address - Phone:201-313-1122
Practice Address - Fax:201-941-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0033641171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty