Healthcare Provider Details

I. General information

NPI: 1902037120
Provider Name (Legal Business Name): MARCO FERRUCCI D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 POMPTON AVE
CEDAR GROVE NJ
07009-1814
US

IV. Provider business mailing address

388 POMPTON AVE
CEDAR GROVE NJ
07009-1814
US

V. Phone/Fax

Practice location:
  • Phone: 973-228-0500
  • Fax: 973-228-0501
Mailing address:
  • Phone: 973-477-8414
  • Fax: 973-228-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00676300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: