Provider Demographics
NPI:1558786517
Name:HUNG, MICHELLE WU (LAC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:WU
Last Name:HUNG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:9 LETTS CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5662
Mailing Address - Country:US
Mailing Address - Phone:973-641-4835
Mailing Address - Fax:
Practice Address - Street 1:9 LETTS CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5662
Practice Address - Country:US
Practice Address - Phone:973-641-4835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00102900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist