Evergreen Acupuncture

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00031800 Issued in NJ

Legal business name

EVERGREEN ACUPUNCTURE

Practice address

2083 Center Ave.
2A
Fort Lee, NJ 07024

Phone

(201) 945-0022

Fax

(877) 371-3713

NPI assigned

Nov 6, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Dorothy Kyungae Chae, L.AC., PH.D.NPI 1366755233

Title

President

Phone

(201) 945-0022

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dorothy Kyungae Chae, L. AC

  • Acupuncturist
  • Fort Lee, NJ
  • NPI 1366755233
  NPD (past) Authorized official

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

{
    "created_epoch": "1289001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1295036291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2083 CENTER AVE.",
            "address_2": "2A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-945-0022",
            "fax_number": "877-371-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 CENTER AVE.",
            "address_2": "2A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-945-0022",
            "fax_number": "877-371-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-06",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "CHAE",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "KYUNGAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-945-0022",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.AC., PH.D."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00031800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.