Provider Demographics
NPI:1932613429
Name:AUDI, RAMI SEBASTIAN
Entity Type:Individual
Prefix:MR
First Name:RAMI
Middle Name:SEBASTIAN
Last Name:AUDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SCHIMMEL ST
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5314
Mailing Address - Country:US
Mailing Address - Phone:201-588-9144
Mailing Address - Fax:
Practice Address - Street 1:617 ORADELL AVE STE 9
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1732
Practice Address - Country:US
Practice Address - Phone:201-588-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00102600225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ18KT00102600OtherMASSAGE AND BODY THERAPY