NPIMap

Organization Active NPI

Acupuncture Health and Wellness PC

  • Acupuncturist
  • Fair Lawn, NJ
National Provider Identifier
1356090419
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
ACUPUNCTURE HEALTH AND WELLNESS PC
Practice address
16-00 Route 208 Ste 204
Fair Lawn, NJ 07410-2506
Phone
(201) 880-6207
Fax
(201) 880-6208
NPI assigned
Mar 23, 2022
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Mr. Roman Khodik, LAC, MSACNPI 1588171318
Title
Acupuncturist/Owner
Phone
(201) 880-6207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

16-00 Route 208 Ste 204
Fair Lawn, NJ 07410-2506

Mailing address

9-09 Elaine Ter
Fair Lawn, NJ 07410-5714
Phone (201) 880-6207

National Provider Directory

National Provider Directory

Locations

16-00 Route 208
Ste 204
Fair Lawn, NJ 07410
Phone (201) 880-6207

Practitioners & affiliated clinicians

Practitioners 6

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": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1356090419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9-09 ELAINE TER",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105714",
            "telephone_number": "201-880-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-00 ROUTE 208 STE 204",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102506",
            "telephone_number": "201-880-6207",
            "fax_number": "201-880-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUPUNCTURE HEALTH AND WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "KHODIK",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "ACUPUNCTURIST/OWNER",
        "authorized_official_telephone_number": "201-880-6207",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAC, MSAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 23, 2022; 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.