Provider Demographics
NPI:1346363439
Name:RACCIATTI-PARKER, JOANNE PATRICIA (CA)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:PATRICIA
Last Name:RACCIATTI-PARKER
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 E DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2304
Mailing Address - Country:US
Mailing Address - Phone:609-730-8534
Mailing Address - Fax:
Practice Address - Street 1:114 STRAUBE CENTER BOULEVARD, SUITE K1-6
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2304
Practice Address - Country:US
Practice Address - Phone:609-730-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00029400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist