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General NPI Number Information
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NPI Number | 1891842357
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Entity Type | Individual
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Provider Name | PAULA V REDHEAD L.AC,C.A,DIPL O.M
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 01/03/2021
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Provider Practice Location Address
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Address Line | 315 STATE ROUTE 34 STE 133
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City | COLTS NECK
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State | NJ
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Zip | 07722-2444
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Country | US
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Telephone | 732-213-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 45 OCEAN AVE 5 E
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City | MONMOUTH BEACH
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State | NJ
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Zip | 07750-1301
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Country | US
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Telephone | 732-213-5222
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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 | 25MZ00022600
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License Number State | NJ
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