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Organization
NJ HOLISTIC WELLNESS CENTER LLC
Active
Organization
NJ HOLISTIC WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK WONG (MANAGER)
(917) 981-0080
Entity
Organization
Contact information
Practice address
31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
(201) 746-5329
Mailing address
31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
(201) 746-5329
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00096700
NJ
171100000X
Acupuncturist
25MZ00112100
NJ
171100000X
Acupuncturist
25MZ00115100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225384548
NPI
—
01
—
1679810238
NPI
—
01
—
1801140942
NPI
—
01
—
25MZ00096700
STATE LICENSE
NJ
01
—
25MZ00112100
STATE LICENSE
NJ
01
—
25MZ00115100
STATE LICENSE
NJ
Enumeration date
10/03/2017
Last updated
10/03/2017
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