MEDICARE: DR. CHARLES M PAOLINI DC

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	38MC00120100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P413689	OTHER	NJ	OXFORD INSURANCE

General Provider Information

NPI Number	:	1881684835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES M PAOLINI DC

Provider Business Mailing Address
First Line	:	62 SEMINARY DRIVE
Second Line	:
City	:	MAHWAH
State	:	NJ
Zip	:	07430
Country	:	US
Telephone Number	:	201-818-0991
Fax Number	:	201-818-0994

Provider Business Practice Location Address
First Line	:	62 SEMINARY DRIVE
Second Line	:
City	:	MAHWAH
State	:	NJ
Zip	:	07430
Country	:	US
Telephone Number	:	201-818-0991
Fax Number	:	201-818-0994

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. CHARLES M PAOLINI DC” Practice Location

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