Provider Demographics
NPI:1720332216
Name:MSK HONSHIN MEDICAL ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:MSK HONSHIN MEDICAL ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINI
Authorized Official - Middle Name:PEREZ
Authorized Official - Last Name:ABSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-678-8277
Mailing Address - Street 1:217 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1622
Mailing Address - Country:US
Mailing Address - Phone:609-678-8277
Mailing Address - Fax:
Practice Address - Street 1:5429 HARDING HWY
Practice Address - Street 2:STE 301
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2263
Practice Address - Country:US
Practice Address - Phone:609-678-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07167100261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8792909Medicaid
NJ8792909Medicaid