Provider Demographics
NPI:1407564370
Name:DEMARIE, NEYDA (LMT, C-MLDT)
Entity Type:Individual
Prefix:
First Name:NEYDA
Middle Name:
Last Name:DEMARIE
Suffix:
Gender:F
Credentials:LMT, C-MLDT
Other - Prefix:
Other - First Name:NEYDA
Other - Middle Name:LUZ
Other - Last Name:FIGUEROA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LM
Mailing Address - Street 1:956 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2653
Mailing Address - Country:US
Mailing Address - Phone:732-586-6610
Mailing Address - Fax:
Practice Address - Street 1:1465 ROUTE 31 S
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3129
Practice Address - Country:US
Practice Address - Phone:908-735-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00129400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist