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General NPI Number Information
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NPI Number | 1760713366
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Entity Type | Individual
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Provider Name | CAROLYN MARIE RAIMAN C.A.
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Gender | Female
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 1040 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-3511
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Country | US
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Telephone | 888-894-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 181 RYDER WAY
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City | NEW PROVIDENCE
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State | NJ
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Zip | 07974-1222
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Country | US
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Telephone | 908-790-9123
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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 | MZ00048900
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License Number State | NJ
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