MEDICARE: DR. JOHN JOSEPH RAIO 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	38MC00332900	NJ

General Provider Information

NPI Number	:	1619975018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH RAIO D.C.

Provider Business Mailing Address
First Line	:	333 PASSAIC AVE
Second Line	:
City	:	WEST CALDWELL
State	:	NJ
Zip	:	07006-8035
Country	:	US
Telephone Number	:	973-808-8485
Fax Number	:	973-808-2922

Provider Business Practice Location Address
First Line	:	333 PASSAIC AVE
Second Line	:
City	:	WEST CALDWELL
State	:	NJ
Zip	:	07006-8035
Country	:	US
Telephone Number	:	973-808-8485
Fax Number	:	973-808-2922

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

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	07/08/2007

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