# NJ HOLISTIC WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1295245363
- **Authorized official:** PATRICK WONG (MANAGER)
- **Authorized official phone:** (917) 981-0080

## Contact information

- **Practice address:** 31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
- **Practice address phone:** (201) 746-5329
- **Mailing address:** 31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
- **Mailing address phone:** (201) 746-5329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 25MZ00096700 | NJ | Yes |
| 171100000X | Acupuncturist | 25MZ00112100 | NJ | — |
| 171100000X | Acupuncturist | 25MZ00115100 | NJ | — |

## Other

- **Enumeration date:** 10/03/2017
- **Last updated:** 10/03/2017

## 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 |