Provider Demographics
NPI:1932504719
Name:LUMINOSITY ACUPUNCTURE & WELLNESS CENTER
Entity Type:Organization
Organization Name:LUMINOSITY ACUPUNCTURE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:973-316-1768
Mailing Address - Street 1:271 RTE 46 W
Mailing Address - Street 2:SUITE A109
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-2440
Mailing Address - Country:US
Mailing Address - Phone:973-316-1768
Mailing Address - Fax:
Practice Address - Street 1:271 RTE 46 W
Practice Address - Street 2:SUITE A109
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2440
Practice Address - Country:US
Practice Address - Phone:973-316-1768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00066000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty