Provider Demographics
NPI:1649778879
Name:SAGE ACUPUNCTURE & HERBAL CLINIC LLC
Entity Type:Organization
Organization Name:SAGE ACUPUNCTURE & HERBAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KI YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-745-2882
Mailing Address - Street 1:251 ROCK RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1797
Mailing Address - Country:US
Mailing Address - Phone:201-745-2882
Mailing Address - Fax:
Practice Address - Street 1:251 ROCK RD STE 2B
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1797
Practice Address - Country:US
Practice Address - Phone:201-745-2882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty