Provider Demographics
NPI:1548809577
Name:OLINISKI, JULIANNE MARCELLY (LAC)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:MARCELLY
Last Name:OLINISKI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5076
Mailing Address - Country:US
Mailing Address - Phone:732-686-9416
Mailing Address - Fax:
Practice Address - Street 1:29 ALDEN ST STE 1A
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2156
Practice Address - Country:US
Practice Address - Phone:908-276-0294
Practice Address - Fax:908-276-0753
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00144100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist