Provider Demographics
NPI:1427800176
Name:AMORIM, ALICE DOS SANTOS (LMT)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:DOS SANTOS
Last Name:AMORIM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1187
Mailing Address - Country:US
Mailing Address - Phone:908-290-2277
Mailing Address - Fax:
Practice Address - Street 1:348 MONROE AVE
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1187
Practice Address - Country:US
Practice Address - Phone:908-290-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00185100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist