Provider Demographics
NPI:1679942957
Name:GOODPOINT MEDICINE P. C.
Entity Type:Organization
Organization Name:GOODPOINT MEDICINE P. C.
Other - Org Name:YANG WELLNESS CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HUI-TZU
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:973-910-8288
Mailing Address - Street 1:155 PROSPECT AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4204
Mailing Address - Country:US
Mailing Address - Phone:973-910-8288
Mailing Address - Fax:973-910-8289
Practice Address - Street 1:155 PROSPECT AVE STE 205
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-910-8288
Practice Address - Fax:973-910-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004939171100000X
NJ25MZ00112800171100000X
NJ25MA07359300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP5938350OtherOXFORD PROVIDER ID
NJ625950000OtherCONDUENT