=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942375951
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH N NUZIALE DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 240 WEST PASSAIC STREET
-----------------------------------------------------
City | MAYWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-843-6363
-----------------------------------------------------
Fax | 201-843-1089
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 240 WEST PASSAIC STREET
-----------------------------------------------------
City | MAYWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-843-6363
-----------------------------------------------------
Fax | 201-843-1089
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00268500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------