Provider Demographics
NPI:1548332984
Name:CAMP, DANIELLE LORRAINE (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:LORRAINE
Last Name:CAMP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-1424
Mailing Address - Country:US
Mailing Address - Phone:609-569-0224
Mailing Address - Fax:609-407-2122
Practice Address - Street 1:2 E PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-1424
Practice Address - Country:US
Practice Address - Phone:609-569-0224
Practice Address - Fax:609-407-2122
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MCO00526200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ039924Medicare UPIN