Provider Demographics
NPI:1568616456
Name:GRIFFAULT, JULIEN (MT,NCTMB)
Entity Type:Individual
Prefix:MR
First Name:JULIEN
Middle Name:
Last Name:GRIFFAULT
Suffix:
Gender:M
Credentials:MT,NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 SOUTH AVE E
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1465
Mailing Address - Country:US
Mailing Address - Phone:908-477-0188
Mailing Address - Fax:
Practice Address - Street 1:361 SOUTH AVE E
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1465
Practice Address - Country:US
Practice Address - Phone:908-477-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00146500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist