Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | 1431 | ZZ |
Y | 225700000X | Massage Therapist | 18KT00261400 | NJ |
NPI | 1215476411 |
---|---|
Provider Name | Lalithambika Nair |
First Address | North Brunswick, NJ 08902-1061 |
Second Address | North Brunswick, NJ 08902-1061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2017 |
Last Update Date | 28/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18KT00261400 | MASSAGE AND BODY WORK THERAPY (01) | NJ |