Provider Demographics
NPI:1437433174
Name:PATUTO, ADELYN N (L AC)
Entity Type:Individual
Prefix:
First Name:ADELYN
Middle Name:N
Last Name:PATUTO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2237
Mailing Address - Country:US
Mailing Address - Phone:646-594-7882
Mailing Address - Fax:888-537-7558
Practice Address - Street 1:37 FAIRWAY AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2237
Practice Address - Country:US
Practice Address - Phone:646-594-7882
Practice Address - Fax:888-537-7558
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00072900171100000X
NY003766171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist