Provider Demographics
NPI:1619286556
Name:HOLISTIC VISION ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:HOLISTIC VISION ACUPUNCTURE LLC
Other - Org Name:TIGER ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BONACCI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:609-751-4654
Mailing Address - Street 1:20 NASSAU ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-4509
Mailing Address - Country:US
Mailing Address - Phone:609-751-4654
Mailing Address - Fax:
Practice Address - Street 1:20 NASSAU ST
Practice Address - Street 2:SUITE 206
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-4509
Practice Address - Country:US
Practice Address - Phone:609-751-4654
Practice Address - Fax:609-228-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00077500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty