Provider Demographics
NPI:1972239721
Name:ARIAS, PRISCILLA (LAC)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:ARIAS
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:PO BOX 1035
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1035
Mailing Address - Country:US
Mailing Address - Phone:908-248-4059
Mailing Address - Fax:
Practice Address - Street 1:1 OLD WOLFE RD STE 208
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-3213
Practice Address - Country:US
Practice Address - Phone:973-527-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty