1275114233 NPI number — YE2 ACUPUNCTURE CLINIC LLC

Table of content: (NPI 1275114233)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275114233 NPI number — YE2 ACUPUNCTURE CLINIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YE2 ACUPUNCTURE CLINIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275114233
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
321 BROAD AVE STE 106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGEFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07657-2338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-917-3005
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3425 LIMEKILN PIKE STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHALFONT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18914-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-997-7878
Provider Business Practice Location Address Fax Number:
215-997-7879
Provider Enumeration Date:
04/20/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HA
Authorized Official First Name:
KWANGYI
Authorized Official Middle Name:
Authorized Official Title or Position:
ACUPUNCTURIST
Authorized Official Telephone Number:
201-917-3005

Provider Taxonomy Codes

  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)