NPIMap

Organization Active NPI

NJ Holistic Wellness Center LLC

  • Acupuncturist
  • Fair Lawn, NJ
National Provider Identifier
1295245363
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00096700 Issued in NJ
Legal business name
NJ HOLISTIC WELLNESS CENTER LLC
Practice address
31-00 Broadway
Fair Lawn, NJ 07410-3963
Phone
(201) 746-5329
NPI assigned
Oct 3, 2017
Last updated
Oct 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Authorized official

Name
Patrick WongNPI 1679810238
Title
Manager
Phone
(917) 981-0080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00115100 NJ
Acupuncturist 171100000X 25MZ00112100 NJ
Acupuncturist 171100000X 25MZ00096700 NJ Primary

Addresses

Primary practice location

31-00 Broadway
Fair Lawn, NJ 07410-3963

Mailing address

31-00 Broadway
Fair Lawn, NJ 07410-3963
Phone (201) 746-5329

Other identifiers 6

IdentifierTypeStateIssuer
25MZ00115100OtherNJSTATE LICENSE
25MZ00112100OtherNJSTATE LICENSE
1225384548OtherNPI
1679810238OtherNPI
1801140942OtherNPI
25MZ00096700OtherNJSTATE LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1295245363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31-00 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103963",
            "telephone_number": "201-746-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31-00 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103963",
            "telephone_number": "201-746-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ HOLISTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-981-0080"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00115100",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00112100",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00096700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MZ00115100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MZ00112100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225384548",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679810238",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801140942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MZ00096700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.