Provider Demographics
NPI:1811292535
Name:CHOIRAZZO, JILL (L AC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CHOIRAZZO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1718
Mailing Address - Country:US
Mailing Address - Phone:201-403-4253
Mailing Address - Fax:973-478-2123
Practice Address - Street 1:95 MAPLE ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1718
Practice Address - Country:US
Practice Address - Phone:201-403-4253
Practice Address - Fax:973-478-2123
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00078000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist