Provider Demographics
NPI:1376190355
Name:REIMANN, EMILY P (LAC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:REIMANN
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 1:66D BROOKSIDE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1705
Mailing Address - Country:US
Mailing Address - Phone:201-310-1703
Mailing Address - Fax:
Practice Address - Street 1:18 SYCAMORE AVE STE 2
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1500
Practice Address - Country:US
Practice Address - Phone:201-857-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00140600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist