Provider Demographics
NPI:1861775215
Name:BRUNELLI, ANA I (CMT)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:I
Last Name:BRUNELLI
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4530
Mailing Address - Country:US
Mailing Address - Phone:201-755-6363
Mailing Address - Fax:
Practice Address - Street 1:666 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4530
Practice Address - Country:US
Practice Address - Phone:201-755-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00006100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist