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General NPI Number Information
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NPI Number | 1366136715
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Entity Type | Individual
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Provider Name | MARY SHAWKI RASSLA D.AC, L.AC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 100 CABOT DR STE A
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City | HAMILTON
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State | NJ
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Zip | 08691-3202
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Country | US
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Telephone | 609-528-4417
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Fax |
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Provider Business Mailing Address
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Address Line | 11 COLIN ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3627
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Country | US
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Telephone | 551-221-2708
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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 | 849393
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License Number State | NJ
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