Provider Demographics
NPI:1891842357
Name:REDHEAD, PAULA V (LAC,CA,DIPL OM)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:V
Last Name:REDHEAD
Suffix:
Gender:F
Credentials:LAC,CA,DIPL OM
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:V
Other - Last Name:REDHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 OCEAN AVE
Mailing Address - Street 2:5 E
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750-1301
Mailing Address - Country:US
Mailing Address - Phone:732-213-5222
Mailing Address - Fax:
Practice Address - Street 1:315 STATE ROUTE 34 STE 133
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2444
Practice Address - Country:US
Practice Address - Phone:732-213-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00022600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist