Provider Demographics
NPI:1669913729
Name:ACUMERIDIAN WELLNESS LLC
Entity type:Organization
Organization Name:ACUMERIDIAN WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOO
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:732-858-1322
Mailing Address - Street 1:242 RTE 79 N
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2078
Mailing Address - Country:US
Mailing Address - Phone:732-858-1322
Mailing Address - Fax:855-755-7778
Practice Address - Street 1:242 RTE 79 N
Practice Address - Street 2:SUITE 11
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-2078
Practice Address - Country:US
Practice Address - Phone:732-858-1322
Practice Address - Fax:855-755-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00102500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty