Provider Demographics
NPI:1891353207
Name:GOOD HEALTH ACUPUNCTURE
Entity Type:Organization
Organization Name:GOOD HEALTH ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:V
Authorized Official - Last Name:PISAREVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-371-7083
Mailing Address - Street 1:15 ROSEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3607
Mailing Address - Country:US
Mailing Address - Phone:862-371-7083
Mailing Address - Fax:
Practice Address - Street 1:15 ROSEWOOD TER
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3607
Practice Address - Country:US
Practice Address - Phone:862-371-7083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty