Provider Demographics
NPI:1669892444
Name:ACU WELL OF AMERICA , INC
Entity type:Organization
Organization Name:ACU WELL OF AMERICA , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-327-1990
Mailing Address - Street 1:171 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2089
Mailing Address - Country:US
Mailing Address - Phone:201-327-1990
Mailing Address - Fax:201-327-1921
Practice Address - Street 1:171 LAKE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2089
Practice Address - Country:US
Practice Address - Phone:201-327-1990
Practice Address - Fax:201-327-1921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00070600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty