Provider Demographics
NPI:1871001875
Name:BEAUTIFUL ACUPUNCTURE
Entity Type:Organization
Organization Name:BEAUTIFUL ACUPUNCTURE
Other - Org Name:BEAUTIFUL ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LA.C
Authorized Official - Prefix:
Authorized Official - First Name:AREUM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-716-1239
Mailing Address - Street 1:161 CHERRY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-4833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:161 CHERRY ST STE 2
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-4833
Practice Address - Country:US
Practice Address - Phone:203-716-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000711171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000711OtherLICENSE