Provider Demographics
NPI:1841856549
Name:IULIUCCI, KRISTA LYNN
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:LYNN
Last Name:IULIUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 MIDDLESEX AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2054
Mailing Address - Country:US
Mailing Address - Phone:609-868-2937
Mailing Address - Fax:
Practice Address - Street 1:177 WASHINGTON VALLEY RD STE 16
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7210
Practice Address - Country:US
Practice Address - Phone:732-622-0106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist