Active NPI
Longfellow Song, L AC
- Acupuncturist
- Palisades Park, NJ
National Provider Identifier
1407319247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00075100
- Practice address
- 232 Broad Ave Ste 208
Palisades Park, NJ 07650-1565 - Phone
- (201) 944-2558
- NPI assigned
- Apr 9, 2019
- Last updated
- Apr 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00075100 | NJ | Primary |
Addresses
Primary practice location
232 Broad Ave Ste 208
Palisades Park, NJ 07650-1565
Mailing address
232 Broad Ave Ste 208
Palisades Park, NJ 07650-1565
Phone (201) 944-2558
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MZ00075100 | Other | NJ | ACUPUNCTURE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00075100 | NJ | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1407319247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 BROAD AVE STE 208",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501565",
"telephone_number": "201-944-2558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 BROAD AVE STE 208",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501565",
"telephone_number": "201-944-2558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "LONGFELLOW",
"credential": "L AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-09",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00075100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACUPUNCTURE",
"identifier": "25MZ00075100",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palisades Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.