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General NPI Number Information
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NPI Number | 1366670523
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Entity Type | Individual
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Provider Name | CRISTINA R. DE LA MAR M.S., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 150 MORRIS AVE STE 305
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1329
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Country | US
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Telephone | 917-210-1063
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Fax |
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Provider Business Mailing Address
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Address Line | 20 MOUNTAIN AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2542
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Country | US
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Telephone | 917-210-1063
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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 | 3980
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00113800
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License Number State | NJ
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