Provider Demographics
NPI:1720503626
Name:NATURAL JADE ACUPUNCTURE AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:NATURAL JADE ACUPUNCTURE AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:YU
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-229-6512
Mailing Address - Street 1:120 SHREWSBURY CT
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5409
Mailing Address - Country:US
Mailing Address - Phone:607-229-6512
Mailing Address - Fax:
Practice Address - Street 1:713 EXECUTIVE DR UNIT 713
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1529
Practice Address - Country:US
Practice Address - Phone:607-229-6512
Practice Address - Fax:609-482-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty