Provider Demographics
NPI:1396176665
Name:AFFINITY HEALING CENTERS LLC
Entity type:Organization
Organization Name:AFFINITY HEALING CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:ELSIE
Authorized Official - Last Name:CUBERO
Authorized Official - Suffix:
Authorized Official - Credentials:L AC, MSOM, LMT
Authorized Official - Phone:201-220-7055
Mailing Address - Street 1:24 RIVER RD STE 209
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1522
Mailing Address - Country:US
Mailing Address - Phone:201-220-7055
Mailing Address - Fax:
Practice Address - Street 1:24 RIVER RD STE 209
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1522
Practice Address - Country:US
Practice Address - Phone:201-220-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005098-1171100000X
NJ25MZ00103900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty