Jae Yong Chang, L.AC.

Individual provider Active NPI Acupuncturist · Ridgefield, NJ

NPI 1124387287 · NPPES record last updated Mar 28, 2023

Key facts

NPI
1124387287
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
25MZ00030400 (NJ)
Practice address
579 Bergen Blvd FL 2
Ridgefield, NJ 07657-2032
Phone
(201) 945-4372
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
25MZ00030400NJMDAcupuncturist
001627NYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Changs Acupuncture & Herbs, PC Acupuncturist Current
since Apr 6, 2023
Accepting new patients

Locations

579 Bergen Blvd
Fl 2
Ridgefield, NJ 07657
Phone (201) 945-4372

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00030400 NJ Yes
Acupuncturist 171100000X 001627 NY

Addresses

Primary practice location

579 Bergen Blvd FL 2
Ridgefield, NJ 07657-2032

Mailing address

2486 5TH St
Fort Lee, NJ 07024-7840
Phone (201) 945-4372

Other providers in Ridgefield, NJ

All providers in Ridgefield, NJ · Acupuncturist in New Jersey

Sources for this page

Verify at the official NPI Registry.