# PINE ACUPUNCTURE & HERBAL MEDICINE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205160579
- **Authorized official:** DOAM KIM (OWNER)
- **Authorized official phone:** (201) 585-8285

## Contact information

- **Practice address:** 166 MAIN ST, \#2B, FORT LEE, NJ 07024-6922
- **Practice address phone:** (201) 585-8285
- **Mailing address:** 166 MAIN ST, \#2B, FORT LEE, NJ 07024-6922
- **Mailing address phone:** (201) 585-8285

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | MZ00016800 | NJ | Yes |

## Other

- **Enumeration date:** 09/19/2009
- **Last updated:** 09/19/2009