Individual
SO-YOUNG VANDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 EAGLE ROCK AVE STE 2, ROSELAND, NJ 07068-1354
(973) 932-4195
Mailing address
3100 RACHEL TER APT 15, PINE BROOK, NJ 07058-9347
(973) 932-4195
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00175200
NJ
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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