Provider Demographics
NPI:1073881223
Name:SAFIAN, PATRICIA (MS, LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SAFIAN
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PARK ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-5907
Mailing Address - Country:US
Mailing Address - Phone:973-233-1195
Mailing Address - Fax:973-707-2532
Practice Address - Street 1:70 PARK ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5907
Practice Address - Country:US
Practice Address - Phone:973-233-1195
Practice Address - Fax:973-707-2532
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ0004940171100000X
NY00218171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist