Provider Demographics
NPI:1790232825
Name:ONE ACUPUNCTURE & HERBS, PC
Entity Type:Organization
Organization Name:ONE ACUPUNCTURE & HERBS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONGKEUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-862-1110
Mailing Address - Street 1:765 TEANECK RD.
Mailing Address - Street 2:GROUND FL.
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-862-1110
Mailing Address - Fax:201-862-1154
Practice Address - Street 1:765 TEANECK RD
Practice Address - Street 2:GROUND FL.
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4248
Practice Address - Country:US
Practice Address - Phone:201-862-1110
Practice Address - Fax:201-862-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00081200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty