Provider Demographics
NPI:1780218214
Name:TWIN RIVERS ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:TWIN RIVERS ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ACUPUNCTURE AND CHINESE M
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:732-659-4662
Mailing Address - Street 1:541 NETTLETON DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5330
Mailing Address - Country:US
Mailing Address - Phone:732-659-4662
Mailing Address - Fax:
Practice Address - Street 1:541 NETTLETON DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5330
Practice Address - Country:US
Practice Address - Phone:732-659-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty