Provider Demographics
NPI:1801455977
Name:PEACE ACUPUNCTURE CLINIC LLC
Entity type:Organization
Organization Name:PEACE ACUPUNCTURE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYOUNGSOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKUMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:908-309-8857
Mailing Address - Street 1:36 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3457
Mailing Address - Country:US
Mailing Address - Phone:908-309-8857
Mailing Address - Fax:732-542-3367
Practice Address - Street 1:620 TINTON AVE.
Practice Address - Street 2:BUILDING A, SUITE 202
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3260
Practice Address - Country:US
Practice Address - Phone:908-309-8857
Practice Address - Fax:732-542-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty