JAEDOO LEE (NPI# 1881057412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881057412 |
| Entity Type | Individual |
| Full Name | JAEDOO LEE |
| Practice Address |
118 Broad Ave N9 Palisades Park NJ 07650-2717 |
| Mailing Address |
118 Broad Ave Ste N9 Palisades Park NJ 07650-2721 |
| Practice Telephone | 2014820439 |
| Practice Fax Number | 2014828703 |
| Mailing Telephone | 2014820469 |
| Mailing Fax Number | 2014828703 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 38MC00733100 | NJ | Chiropractic Providers |
| Street Address |
118 BROAD AVE N9 |
| City | PALISADES PARK |
| State | NJ |
| Zip Code | 07650-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679671606 | 7 Aleftv, Inc. | Pharmacy | 118 Broad Ave, Suite N4, Palisades Park, NJ 07650-2717 | 2006-09-21 |
| 1730631466 | Hyeyoung Park | Nurse Practitioner | 118 Broad Ave, Ste N10, Palisades Park, NJ 07650-2717 | 2016-10-28 |
| 1588114060 | Prime Diagnostics, P.C. | Specialist | 118 Broad Ave, N9, Palisades Park, NJ 07650-2717 | 2016-10-10 |
| 1598168882 | Prime Diagnostics PC | Legal Medicine | 118 Broad Ave, Unit N9, Palisades Park, NJ 07650-2717 | 2014-10-01 |
| 1558774778 | Prime Acupuncture Care PC | Acupuncturist | 118 Broad Ave, Suite N10, Palisades Park, NJ 07650-2717 | 2014-06-05 |
| 1487067724 | Prime Chiropractic PC | Chiropractor | 118 Broad Ave, Suite N10, Palisades Park, NJ 07650-2717 | 2014-06-04 |
| 1437579505 | Prime Pain Clinic P.C. | Physical Therapist | 118 Broad Ave, Ste N10, Palisades Park, NJ 07650 | 2014-04-16 |
| 1033550017 | Jeannie S Joo | Pharmacist | 118 Broad Ave, Suite N4, Palisades Park, NJ 07650-2717 | 2013-07-08 |
| 1134350648 | E-plant Dental, P.C. | Dentist | 118 Broad Ave, #n-10, Palisades Park, NJ 07650-2717 | 2009-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356902134 | Balance Dizziness Center Inc. | Psychiatry & Neurology | 17 Brinkerhoff Terrace, Palisades Park, NJ 07650 | 2019-06-24 |
| 1437631371 | Catherine Jang | Pharmacist | 113 Roosevelt Pl, Palisades Park, NJ 07650 | 2018-09-06 |
| 1063911782 | Jinwoo Kim | Acupuncturist | 58w Oakdene Ave, Unit A, Palisades Park, NJ 07650 | 2018-02-08 |
| 1275053563 | Prime Painmanagement PC | Physical Medicine & Rehabilitation | 118-126 Broad Avenue, Unit 11, Palisades Park, NJ 07650 | 2017-06-27 |
| 1366836520 | George Xenakis, Dds, Palisades Park, LLC | Clinic/Center | 261a Broad Ave, Palisades Park, NJ 07650 | 2015-03-26 |
| 1245637842 | Sun Young Lee | Nurse Practitioner | 11 West Harriet Ave, Apt 102, Palisades Park, NJ 07650 | 2014-11-25 |
| 1063824290 | Daehwan Ji | Acupuncturist | 460 Bergen Blvd Suite #304, Palisades Park, NJ 07650 | 2014-05-22 |
| 1295084739 | Minhyun Cho | Counselor | 19 E Central Blvd, Palisades Park, NJ 07650 | 2012-08-30 |
| 1255693164 | Juliana A Vasquez | Specialist | 446 7th Street, Palisades Park, NJ 07650 | 2012-06-15 |
| 1295019529 | Now Pain Clinc PC | Residential Treatment Facility, Physical Disabilities | 21 Grand Ave #502, Palisades Park, NJ 07650 | 2011-10-05 |
| Find all providers in zip 07650 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154859122 | Prime Total Pain Clinic PC | Chiropractor | 118 Broad Ave Ste 10, Palisades Park, NJ 07650-2717 | 2017-06-02 |
| 1215395132 | Prime Spinecare | Chiropractor | 118 Broad Ave Ste N9, Palisades Park, NJ 07650-2721 | 2016-02-05 |
| 1245601335 | Sungsik Kim | Chiropractor | 21 Grand Ave Ste 516, Palisades Park, NJ 07650-1083 | 2015-10-14 |
| 1346626645 | Charles Ryu | Chiropractor | 110 Roff Ave Unit A, Palisades Park, NJ 07650-1431 | 2015-08-10 |
| 1891107124 | Prime Chiropractic PC | Chiropractor | 118 Broad Ave Ste 9, Palisades Park, NJ 07650-2717 | 2014-05-21 |
| 1124324009 | Nj Pain Center PC | Chiropractor | 21 Grand Ave Ste 503, Palisades Park, NJ 07650-1083 | 2011-02-09 |
| 1497070734 | Jonathan Jaeyoung Kim | Chiropractor | 7 Broad Ave Ste 309, Palisades Park, NJ 07650-1886 | 2010-03-30 |
| 1558319939 | John Frederick Cerutti | Chiropractor | 545 Broad Ave, Palisades Park, NJ 07650-1607 | 2006-05-05 |
| 1346796349 | Bareun Spine Clinic Inc | Chiropractor | 21 Grand Ave Fl 1, Suite 516, Palisades Park, NJ 07650-1076 | 2016-08-30 |
| 1801262258 | Elite Physical Medicine LLC | Chiropractor | 101 Grand Ave, Palisades Park, NJ 07650-1007 | 2015-08-19 |
| Find all providers in PALISADES PARK | ||||
| City | PALISADES PARK |
| Zip Code | 07650 |
Please comment or provide details below to improve the information on JAEDOO LEE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.