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Individual

MR. MITCHEL JONATHAN CHALEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC.

Contact information

Practice address
33 PLYMOUTH ST, SUITE 107, MONTCLAIR, NJ 07042-2677
(973) 744-7539
Mailing address
33 PLYMOUTH ST, SUITE 107, MONTCLAIR, NJ 07042-2677
(973) 744-7539

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
001181-1
NY
171100000X
Acupuncturist
Primary
25MZ00015000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00118-1
LICENSED ACUPUNCTURIST
NY
01
25MZ00015000
LICENCED ACUPUNCTURIST
NJ
Enumeration date
06/07/2007
Last updated
08/19/2011
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