Provider Demographics
NPI:1134218019
Name:ROYTMAN, IRINA (L AC, DIPL OM)
Entity type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:ROYTMAN
Suffix:
Gender:F
Credentials:L AC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KILMER DR
Mailing Address - Street 2:BUILDING #3, STE.215
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1564
Mailing Address - Country:US
Mailing Address - Phone:732-740-7709
Mailing Address - Fax:732-677-3636
Practice Address - Street 1:426 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3609
Practice Address - Country:US
Practice Address - Phone:732-740-7709
Practice Address - Fax:732-677-3636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MZ00038500171100000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175L00000XOther Service ProvidersHomeopath