1124323092 NPI number — MS. JULIA PEI-JU RIAO L.AC.

Table of content: MS. JULIA PEI-JU RIAO L.AC. (NPI 1124323092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124323092 NPI number — MS. JULIA PEI-JU RIAO L.AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIAO
Provider First Name:
JULIA PEI-JU
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124323092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 E MAIN ST STE 11
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07834-2171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-586-8888
Provider Business Mailing Address Fax Number:
973-586-4372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1259 ROUTE 46 EAST
Provider Second Line Business Practice Location Address:
BUILDING 3
Provider Business Practice Location Address City Name:
PARSIPPANY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-402-8535
Provider Business Practice Location Address Fax Number:
973-586-4372
Provider Enumeration Date:
01/24/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  25MZ00040600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)