Provider Demographics
NPI:1801189808
Name:NJ ACU-MED LLC
Entity Type:Organization
Organization Name:NJ ACU-MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L. ACUPUNCTURIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:201-207-5322
Mailing Address - Street 1:179 CEDAR LANE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-907-5092
Mailing Address - Fax:
Practice Address - Street 1:179 CEDAR LANE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-907-5092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00031800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty