Provider Demographics
NPI:1598214819
Name:STRELNICK, ROSANNA (DACM, LAC)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:
Last Name:STRELNICK
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 S FULLERTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-6303
Mailing Address - Country:US
Mailing Address - Phone:862-622-6289
Mailing Address - Fax:
Practice Address - Street 1:39 S FULLERTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-6303
Practice Address - Country:US
Practice Address - Phone:862-622-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001293171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist