Provider Demographics
NPI:1902604028
Name:JUNIPER HOLISTIC LLC
Entity type:Organization
Organization Name:JUNIPER HOLISTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGELES SEPULVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:908-546-0937
Mailing Address - Street 1:524 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3473
Mailing Address - Country:US
Mailing Address - Phone:908-546-0937
Mailing Address - Fax:
Practice Address - Street 1:524 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3473
Practice Address - Country:US
Practice Address - Phone:908-546-0937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty