MEDICARE: DR. DANIEL JOSEPH COLACHE 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	111NR0400X	Rehabilitation Chiropractor	MC005486	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9804579	OTHER	NJ	CIGNA
2	2248204	OTHER	NJ	UNITED HEALTHCARE
3	7274195	OTHER	NJ	AETNA
4	21203354713 01	OTHER	NJ	BEECHSTREET CORP.
5	NJ05486	OTHER	NJ	ASHN
6	P2753899	OTHER	NJ	OXFORD
7	2010932000	OTHER	NJ	AMERIHEALTH
8	953158	OTHER	NJ	FOCUS
9	1881760	OTHER	NJ	FIRST HEALTH
10	9149091	OTHER	NJ	PHCS
11	969480	OTHER	NJ	ONE HEALTH PLAN / GREAT W

General Provider Information

NPI Number	:	1821173220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSEPH COLACHE D.C.

Provider Business Mailing Address
First Line	:	3934 BLACK HORSE PIKE
Second Line	:	FESTIVAL AT HAMILTON CENTER
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3107
Country	:	US
Telephone Number	:	609-625-6399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3934 BLACK HORSE PIKE
Second Line	:	FESTIVAL AT HAMILTON CENTER
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3107
Country	:	US
Telephone Number	:	609-625-6399
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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