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NPI Code Detail

MEDICARE: PAOLA ANDREA GUTIERREZ

MEDICARE: PAOLA ANDREA GUTIERREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistNJ
2225700000XMassage Therapist

General Provider Information

NPI Number : 1295055234
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAOLA ANDREA GUTIERREZ
Provider Business Mailing Address
First Line : 521 RIVER RD FL 2
Second Line :
City : EDGEWATER
State : NJ
Zip : 07020-1146
Country : US
Telephone Number : 201-943-3030
Fax Number : 201-943-3039
Provider Business Practice Location Address
First Line : 521 RIVER RD FL 2
Second Line :
City : EDGEWATER
State : NJ
Zip : 07020-1146
Country : US
Telephone Number : 201-943-3030
Fax Number : 201-943-3039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2010
Last Update Date : 06/01/2010

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Directions to “ PAOLA ANDREA GUTIERREZ ” Practice Location

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