Provider Demographics
NPI:1871250746
Name:BE WELL OM ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:BE WELL OM ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MYONG
Authorized Official - Middle Name:
Authorized Official - Last Name:OM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-913-3977
Mailing Address - Street 1:7855 BOULEVARD E APT 14B
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5930
Mailing Address - Country:US
Mailing Address - Phone:201-913-3977
Mailing Address - Fax:888-534-5993
Practice Address - Street 1:2 W 46TH ST STE 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4552
Practice Address - Country:US
Practice Address - Phone:201-913-3977
Practice Address - Fax:888-534-5993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty