Provider Demographics
NPI:1194331322
Name:PONCE, NATALIE ESTHER (DIPL OM, LAC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ESTHER
Last Name:PONCE
Suffix:
Gender:F
Credentials:DIPL OM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306
Mailing Address - Country:US
Mailing Address - Phone:201-889-7350
Mailing Address - Fax:
Practice Address - Street 1:500 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1041
Practice Address - Country:US
Practice Address - Phone:201-889-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00146200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist