Holistic Medical LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00091000 Issued in NJ

Legal business name

HOLISTIC MEDICAL LLC

Practice address

140 Sylvan Ave # 107
Englewood Cliffs, NJ 07632-2514

Phone

(201) 944-0985

NPI assigned

Oct 9, 2012

Last updated

Oct 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heebae Kong

Title

Acupuncturist

Phone

(201) 944-0985

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1548512973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SYLVAN AVE # 107",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322514",
            "telephone_number": "201-944-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SYLVAN AVE # 107",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322514",
            "telephone_number": "201-944-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "HEEBAE",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "201-944-0985"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00091000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.