Provider Demographics
NPI:1790262673
Name:YEUNG, IRENE (DACCHM, LAC)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:YEUNG
Suffix:
Gender:F
Credentials:DACCHM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N STATE RT 17 STE 206
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2822
Mailing Address - Country:US
Mailing Address - Phone:201-565-1778
Mailing Address - Fax:
Practice Address - Street 1:140 N STATE RT 17
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2809
Practice Address - Country:US
Practice Address - Phone:201-565-1778
Practice Address - Fax:201-515-5387
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00143000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist