Priscilla Odgers, LAC, MSTOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00073700 Issued in NJ

Practice address

210 Great Bay Blvd
Little Egg Harbor TWP, NJ 08087-2006

Phone

(609) 994-4114

NPI assigned

Dec 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Priscilla Petrosky Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Priscilla Petrosky LLC

  • Acupuncturist
  • Little Egg Harbor TWP, NJ
  • NPI 1194584136
  NPD Authorized official
• Ocean Acupuncture & Herbal Medicine

  • Acupuncturist
  • Manahawkin, NJ
  • NPI 1124338140
  NPD (past)

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1669775003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GREAT BAY BLVD",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080872006",
            "telephone_number": "609-994-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GREAT BAY BLVD",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080872006",
            "telephone_number": "609-994-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODGERS",
        "first_name": "PRISCILLA",
        "name_prefix": "Mrs.",
        "credential": "LAC, MSTOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00073700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "PETROSKY",
            "prefix": "MS.",
            "credential": "LAC, MSTOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Michael Louis Paci Jr., R.PH.
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• Marie Elaina Pangilinan, NBC-WHC

• All providers in Little Egg Harbor TWP, NJ
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.