Provider Demographics
NPI:1912196585
Name:ACUPUNCTURE & CHINESE HERBAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:ACUPUNCTURE & CHINESE HERBAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CA, L AC
Authorized Official - Phone:201-689-2332
Mailing Address - Street 1:1156 E RIDGEWOOD AVE
Mailing Address - Street 2:SUITE NUMBER 15
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3935
Mailing Address - Country:US
Mailing Address - Phone:201-689-2332
Mailing Address - Fax:
Practice Address - Street 1:1156 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE NUMBER 15
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3935
Practice Address - Country:US
Practice Address - Phone:201-689-2332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00017600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty