MEDICARE: DR. JOHN SALVATORE BOCCELLA D.C.

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
1	111N00000X	Chiropractor	2196	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	350045059	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0829C	OTHER	NC	BCBSNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5754696	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1063413771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN SALVATORE BOCCELLA D.C.

Provider Business Mailing Address
First Line	:	10931 STRICKLAND RD
Second Line	:	SUITE 131
City	:	RALEIGH
State	:	NC
Zip	:	27615-2085
Country	:	US
Telephone Number	:	919-518-1234
Fax Number	:	919-518-0878

Provider Business Practice Location Address
First Line	:	10931 STRICKLAND RD
Second Line	:	SUITE 131
City	:	RALEIGH
State	:	NC
Zip	:	27615-2085
Country	:	US
Telephone Number	:	919-518-1234
Fax Number	:	919-518-0878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	12/23/2014

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Directions to “ DR. JOHN SALVATORE BOCCELLA D.C.” Practice Location

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