MEDICARE: ALYSSA MARIE REMANTAS LAC, ATR-P

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
1	101Y00000X	Counselor		NJ

General Provider Information

NPI Number	:	1942012109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MARIE REMANTAS LAC, ATR-P

Provider Business Mailing Address
First Line	:	1 RADAR WAY
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-1290
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 RADAR WAY
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-1290
Country	:	US
Telephone Number	:	732-858-5432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	01/24/2025

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