Provider Demographics
NPI:1487807475
Name:INTEGRAL ACUPUNCTURE
Entity type:Organization
Organization Name:INTEGRAL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ACUPUNCTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JODAR
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:732-545-3800
Mailing Address - Street 1:636 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1975
Mailing Address - Country:US
Mailing Address - Phone:732-545-3800
Mailing Address - Fax:732-545-3801
Practice Address - Street 1:636 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1975
Practice Address - Country:US
Practice Address - Phone:732-545-3800
Practice Address - Fax:732-545-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00045600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty