Jean Haedrich

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00050000 Issued in NJ

Practice address

2787 Kennedy Blvd Ste C11
Jersey City, NJ 07306-5568

Phone

(917) 363-6312

NPI assigned

Jul 17, 2012

Last updated

Apr 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1538414487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2787 KENNEDY BLVD STE C11",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065568",
            "telephone_number": "917-363-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2787 KENNEDY BLVD STE C11",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065568",
            "telephone_number": "917-363-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEDRICH",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00050000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.