Provider Demographics
NPI:1376827394
Name:CAREY, GREGORY ALEXANDER (LIC AC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ALEXANDER
Last Name:CAREY
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TURTLE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8839
Mailing Address - Country:US
Mailing Address - Phone:732-995-5830
Mailing Address - Fax:
Practice Address - Street 1:524 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3312
Practice Address - Country:US
Practice Address - Phone:908-301-9055
Practice Address - Fax:908-301-9056
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00084700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist