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NPI Code Detail

MEDICARE: DR. PASQUALE PUCCIARELLI DC

MEDICARE: DR. PASQUALE PUCCIARELLI DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor38MC00475900NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1223629969OTHERNJTAX IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1003845157
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PASQUALE PUCCIARELLI DC
Provider Business Mailing Address
First Line : 10 N WOOD AVE
Second Line : SUITE E
City : LINDEN
State : NJ
Zip : 07036-5200
Country : US
Telephone Number : 904-474-9444
Fax Number : 908-474-8561
Provider Business Practice Location Address
First Line : 25 COMMERCE DR
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3605
Country : US
Telephone Number : 904-474-9444
Fax Number : 908-474-9440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2006
Last Update Date : 06/12/2025

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Directions to “ DR. PASQUALE PUCCIARELLI DC” Practice Location

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