Individual
SHOU-YUAN FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
500 MOUNT PROSPECT AVE, NEWARK, NJ 07104-2904
(973) 350-0073
Mailing address
500 MOUNT PROSPECT AVE, NEWARK, NJ 07104-2904
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
004232
NY
171100000X
Acupuncturist
Primary
25MZ00073400
NJ
Other
Enumeration date
05/12/2010
Last updated
03/29/2012
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