Provider Demographics
NPI:1972176048
Name:CELENTANO, JULIE MARIE C (LICAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE C
Last Name:CELENTANO
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE C
Other - Last Name:RITUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICAC
Mailing Address - Street 1:801 ALBANY STREET
Mailing Address - Street 2:FL G
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3791
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 CAMBRIDGE ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2743
Practice Address - Country:US
Practice Address - Phone:978-985-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA290413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist