Nicole Elisha Niemkiewicz, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00116700 Issued in NJ

Practice address

196 Cedar St Apt 3C
Cliffside Park, NJ 07010-1280

Phone

(970) 214-8484

NPI assigned

May 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Elisha Green Former name

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1669820809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 CEDAR ST APT 3C",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101280",
            "telephone_number": "970-214-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 CEDAR ST APT 3C",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101280",
            "telephone_number": "970-214-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMKIEWICZ",
        "first_name": "NICOLE",
        "middle_name": "ELISHA",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00116700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GREEN",
            "middle_name": "ELISHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acupuncturist in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.