Jeonghan Lim

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MN00128000 Issued in NJ

Practice address

65 E Northfield Rd Ste D1L
Livingston, NJ 07039-4525

Phone

(862) 370-9202

NPI assigned

Nov 6, 2017

Last updated

Jun 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1124531710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 OVAL RD",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411409",
            "telephone_number": "215-316-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E NORTHFIELD RD STE D1L",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394525",
            "telephone_number": "862-370-9202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69 Oval Rd",
            "address_purpose": "LOCATION",
            "city": "Millburn",
            "state": "NJ",
            "postal_code": "070411409",
            "country_code": "US",
            "telephone_number": "215-316-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "JEONGHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006037",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000852",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MN00128000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Livingston, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.