Provider Demographics
NPI:1760765267
Name:STRASSBERG, CAROLINE (LAC,MAC,MA)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:STRASSBERG
Suffix:
Gender:F
Credentials:LAC,MAC,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 E CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4103
Mailing Address - Country:US
Mailing Address - Phone:503-290-4391
Mailing Address - Fax:
Practice Address - Street 1:108 ORANGE RD STE 301
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2133
Practice Address - Country:US
Practice Address - Phone:503-290-4391
Practice Address - Fax:201-710-5419
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004709171100000X
NJ25MZ00077900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist