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General NPI Number Information
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NPI Number | 1275966251
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Entity Type | Individual
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Provider Name | TAMARA JOY BERISHA L.AC.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 215 ROUTE 31
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5752
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Country | US
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Telephone | 908-788-2589
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Fax |
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Provider Business Mailing Address
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Address Line | 301 HUNT DR
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City | MILFORD
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State | NJ
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Zip | 08848-1856
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Country | US
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Telephone | 908-391-0092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00034300
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License Number State | NJ
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