Mystic Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

MYSTIC ACUPUNCTURE LLC

Practice address

1605 John St Ste 309
Fort Lee, NJ 07024-2583

Phone

(201) 989-8033

NPI assigned

Aug 3, 2018

Organization subpart

No

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

Authorized official

Name

Jin Ju Bae

Title

L.Ac

Phone

(201) 989-8033

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pearl Jinju Bae, LAC

  • Acupuncturist
  • Newark, NJ
  • NPI 1881027506
  NPD

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1851879548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 JOHN ST STE 309",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242583",
            "telephone_number": "201-989-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 JOHN ST STE 309",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242583",
            "telephone_number": "201-989-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "JIN JU",
        "authorized_official_title_or_position": "L.AC",
        "authorized_official_telephone_number": "201-989-8033"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.