Provider Demographics
NPI:1124637640
Name:SUNG LIM ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:SUNG LIM ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNGSOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-240-1234
Mailing Address - Street 1:17 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-5052
Mailing Address - Country:US
Mailing Address - Phone:201-240-1234
Mailing Address - Fax:201-670-7582
Practice Address - Street 1:251 ROCK RD STE 2B
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1797
Practice Address - Country:US
Practice Address - Phone:201-240-1234
Practice Address - Fax:201-670-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health