Pine Acupuncture & Herbal Medicine Clinic

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

MZ00016800 Issued in NJ

Legal business name

PINE ACUPUNCTURE & HERBAL MEDICINE CLINIC

Practice address

166 Main St
#2B
Fort Lee, NJ 07024-6922

Phone

(201) 585-8285

NPI assigned

Sep 19, 2009

Organization subpart

No

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

Authorized official

Name

Doam Kim

Title

Owner

Phone

(201) 585-8285

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253318400000",
    "number": "1205160579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "address_2": "#2B",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246922",
            "telephone_number": "201-585-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "address_2": "#2B",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246922",
            "telephone_number": "201-585-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE ACUPUNCTURE & HERBAL MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-19",
        "last_updated": "2009-09-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DOAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-585-8285"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "MZ00016800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sara Ashley Phillips, LMSW
• Joseph Piacentile, MD
• Vivian Pincus, RDCDE
• Corrine Pineda, OTR/L
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• Health Maintenance Organization in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2009; 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.