Alaethia Doctor, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00094400 Issued in NJ

Practice address

39 Main St
Bradley Beach, NJ 07720-1027

Phone

(347) 709-0848

NPI assigned

Oct 26, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1245583343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MAIN ST",
            "city": "BRADLEY BEACH",
            "state": "NJ",
            "postal_code": "077201027",
            "telephone_number": "347-709-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 MAIN ST",
            "city": "BRADLEY BEACH",
            "state": "NJ",
            "postal_code": "077201027",
            "telephone_number": "347-709-0848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 W 98th St",
            "address_2": "12F",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100255661",
            "country_code": "US",
            "telephone_number": "630-532-1217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "ALAETHIA",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004594",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00094400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Bilas, D.C.
• Bradley Beach Board of Education
• Bradley Beach Pahramcy Inc. (Bradley Beach Pharmacy)
• Thomas Anthony Conklin, LPC
• Valerie Geraldine Darlington
• Jane Dougherty, LPC
• Steven Robert Ferro, PT, DPT
• Zachary D Gubitosi, PT, DPT
• Jillian Ann Hadfield, PT, DPT
• Kelley Higgins, NBC-HWC, MA

• Acupuncturist in Bradley Beach, NJ
• Providers in Bradley Beach, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.