Provider Demographics
NPI:1487914933
Name:ONCARE ACUPUNCTURE & HERB, PC
Entity type:Organization
Organization Name:ONCARE ACUPUNCTURE & HERB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:201-621-3439
Mailing Address - Street 1:240 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1509
Mailing Address - Country:US
Mailing Address - Phone:201-621-3439
Mailing Address - Fax:
Practice Address - Street 1:266 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2514
Practice Address - Country:US
Practice Address - Phone:201-621-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00089800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty