Provider Demographics
NPI:1174705529
Name:VAPHIDES, DEBORAH DIANE (ACUPUNCTURIST)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DIANE
Last Name:VAPHIDES
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:DIANE
Other - Last Name:VAPHIDES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:427 BLOOMFIELD AVENUE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-0704
Mailing Address - Country:US
Mailing Address - Phone:973-744-3555
Mailing Address - Fax:
Practice Address - Street 1:427 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3583
Practice Address - Country:US
Practice Address - Phone:973-744-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00056900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MZ00056900OtherNJ LICENSE NUMBER