Provider Demographics
NPI:1669211017
Name:BERGEN VALLEY ACUPUNCTURE
Entity type:Organization
Organization Name:BERGEN VALLEY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MSTOM
Authorized Official - Phone:201-857-2900
Mailing Address - Street 1:171 E RIDGEWOOD AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3824
Mailing Address - Country:US
Mailing Address - Phone:201-857-2900
Mailing Address - Fax:
Practice Address - Street 1:171 E RIDGEWOOD AVE STE 207
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3824
Practice Address - Country:US
Practice Address - Phone:201-857-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty