Provider Demographics
NPI:1891748349
Name:BALUYOT, RACHEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:BALUYOT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BALUYOT-ESCUSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:68 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1635
Mailing Address - Country:US
Mailing Address - Phone:973-467-3993
Mailing Address - Fax:973-467-9639
Practice Address - Street 1:68 ESSEX ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1635
Practice Address - Country:US
Practice Address - Phone:973-467-3993
Practice Address - Fax:973-467-9639
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00626300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ320131178Medicare UPIN