Provider Demographics
NPI:1538252648
Name:SARRA, ANTHONY JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:SARRA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ANTONIO
Other - Middle Name:J
Other - Last Name:SARRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:108 HAMILTON TRAIL
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512
Mailing Address - Country:US
Mailing Address - Phone:201-343-8974
Mailing Address - Fax:201-343-1015
Practice Address - Street 1:335 - A MAIN STREET
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1503
Practice Address - Country:US
Practice Address - Phone:201-343-8974
Practice Address - Fax:201-343-1015
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC4129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ350038836OtherPALMETTO MEDICARE ID#
NJ223483510OtherHORIZON BLUE CROSS &BS NJ
NJ223483510OtherQUAL CARE
NJX7971OtherEMPIRE BC/BS AND WELLCHOI
NJ223483510OtherQUAL CARE