Provider Demographics
NPI:1790465466
Name:NEW BETHESDA ACUPUNCTURE PC
Entity Type:Organization
Organization Name:NEW BETHESDA ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTRIST
Authorized Official - Prefix:
Authorized Official - First Name:MINGZHI
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-882-1781
Mailing Address - Street 1:5 STONEWALL RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2952
Mailing Address - Country:US
Mailing Address - Phone:917-882-1781
Mailing Address - Fax:201-236-5989
Practice Address - Street 1:5 STONEWALL RD
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2952
Practice Address - Country:US
Practice Address - Phone:917-882-1781
Practice Address - Fax:201-236-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006472OtherLAC