Provider Demographics
NPI:1194027011
Name:SCORDILIS, ALAINA (LAC)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:
Last Name:SCORDILIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 ALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1941
Mailing Address - Country:US
Mailing Address - Phone:973-473-4481
Mailing Address - Fax:973-473-8852
Practice Address - Street 1:925 ALLWOOD RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1941
Practice Address - Country:US
Practice Address - Phone:973-473-4481
Practice Address - Fax:973-473-8852
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00079200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist