Healthcare Provider Details

I. General information

NPI: 1720163801
Provider Name (Legal Business Name): THOMAS MICHAEL CAWLEY JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1153 GREEN STREET
ISELIN NJ
08830
US

IV. Provider business mailing address

1153 GREEN STREET
ISELIN NJ
08830
US

V. Phone/Fax

Practice location:
  • Phone: 732-283-3995
  • Fax: 732-283-3615
Mailing address:
  • Phone: 732-283-3995
  • Fax: 732-283-3615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00241100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX0112471
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: