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NPI Code Detail

MEDICARE: MR. JOHN PANICALI D.C.

MEDICARE:  MR. JOHN  PANICALI  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
1111N00000XChiropractorX4379NY
2111N00000XChiropractor38MC00428800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C043796WOTHERNYWC

General Provider Information

NPI Number : 1265436646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN PANICALI D.C.
Provider Business Mailing Address
First Line : 420 ROUTE 34 STE 331
Second Line :
City : COLTS NECK
State : NJ
Zip : 07722-2517
Country : US
Telephone Number : 732-462-0049
Fax Number : 718-462-0059
Provider Business Practice Location Address
First Line : 420 ROUTE 34 STE 331
Second Line :
City : COLTS NECK
State : NJ
Zip : 07722-2517
Country : US
Telephone Number : 324-620-0497
Fax Number : 324-620-0597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 08/03/2020

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Directions to “ MR. JOHN PANICALI D.C.” Practice Location

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