MEDICARE: LAWRENCE CYRAN & MARIA G CRINCOLI

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	3104	NJ

General Provider Information

NPI Number	:	1588708010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE CYRAN & MARIA G CRINCOLI

Provider Business Mailing Address
First Line	:	944 WESTSIDE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6515
Country	:	US
Telephone Number	:	201-432-3693
Fax Number	:	201-432-3896

Provider Business Practice Location Address
First Line	:	944 WESTSIDE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6515
Country	:	US
Telephone Number	:	201-432-3693
Fax Number	:	201-432-3896

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. LAWRENCE CYRAN
Credential	:	DC
Telephone Number	:	201-432-3693

Provider Enumeration Date	:	02/17/2007
Last Update Date	:	08/22/2020

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