# GRACE ACUPUNCTURE AND HERBAL MEDICINE, LLC

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

## Provider details

- **NPI number:** 1427647395
- **Authorized official:** DR. GRACE J KIM DACM (OWNER)
- **Authorized official phone:** (201) 292-4448

## Contact information

- **Practice address:** 577 CHESTNUT RIDGE RD, WOODCLIFF LAKE, NJ 07677-8409
- **Practice address phone:** (201) 292-4448
- **Mailing address:** 577 CHESTNUT RIDGE RD, WOODCLIFF LAKE, NJ 07677-8409
- **Mailing address phone:** (201) 292-4448
- **Mailing address fax:** (201) 520-1313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2021
- **Last updated:** 07/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 005171 | NY LICENSE NUMBER | NY |
| 01 | — | 1912335001 | INDIVIDUAL NPI | — |
| 01 | — | 25MZ00104400 | NJ LICENSE NUMBER | NJ |