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Organization
GRACE ACUPUNCTURE AND HERBAL MEDICINE, LLC
Active
Organization
GRACE ACUPUNCTURE AND HERBAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE J KIM DACM (OWNER)
(201) 292-4448
Entity
Organization
Contact information
Practice address
577 CHESTNUT RIDGE RD, WOODCLIFF LAKE, NJ 07677-8409
(201) 292-4448
Mailing address
577 CHESTNUT RIDGE RD, WOODCLIFF LAKE, NJ 07677-8409
(201) 292-4448
(201) 520-1313
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005171
NY LICENSE NUMBER
NY
01
—
1912335001
INDIVIDUAL NPI
—
01
—
25MZ00104400
NJ LICENSE NUMBER
NJ
Enumeration date
01/14/2021
Last updated
07/14/2021
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