Active NPI
Kitak Ryu
- Acupuncturist
- Bayonne, NJ
National Provider Identifier
1073002507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00130100
- Practice address
- 777 Avenue C
Bayonne, NJ 07002-2844 - Phone
- (201) 436-0911
- NPI assigned
- May 10, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00130100 | NJ | Primary |
Addresses
Primary practice location
777 Avenue C
Bayonne, NJ 07002-2844
Mailing address
825 Ray Ave
Ridgefield, NJ 07657
Phone (201) 615-8242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00130100 | NJ | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1073002507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 RAY AVE",
"city": "RIDGEFIELD",
"state": "NJ",
"postal_code": "07657",
"telephone_number": "201-615-8242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 AVENUE C",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070022844",
"telephone_number": "201-436-0911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYU",
"first_name": "KITAK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-10",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00130100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.