Provider Demographics
NPI:1750709887
Name:JASENG WELLNESS CORPORATION
Entity type:Organization
Organization Name:JASENG WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-313-4664
Mailing Address - Street 1:333 SYLVAN AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2724
Mailing Address - Country:US
Mailing Address - Phone:201-227-8275
Mailing Address - Fax:714-870-5028
Practice Address - Street 1:333 SYLVAN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2724
Practice Address - Country:US
Practice Address - Phone:201-227-8275
Practice Address - Fax:714-870-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-05
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty