Healthcare Provider Details

I. General information

NPI: 1659235349
Provider Name (Legal Business Name): JANELLE DIANA KRANNICH LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 FRANKLIN ST
BLOOMFIELD NJ
07003-4378
US

IV. Provider business mailing address

649 LITTLETON RD APT 18
PARSIPPANY NJ
07054-4858
US

V. Phone/Fax

Practice location:
  • Phone: 201-396-0079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: