Provider Demographics
NPI:1528046471
Name:MAGGIO, JOSEPH IV (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:MAGGIO
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 KEARNY AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2507
Mailing Address - Country:US
Mailing Address - Phone:201-991-1414
Mailing Address - Fax:201-997-3277
Practice Address - Street 1:267 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2507
Practice Address - Country:US
Practice Address - Phone:201-991-1414
Practice Address - Fax:201-997-3277
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00282100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU47912Medicare UPIN
NJMA755625Medicare ID - Type Unspecified