Provider Demographics
NPI:1861523763
Name:SOLAN, JOHN JOSEPH III (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:SOLAN
Suffix:III
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 1:1924 HWY 35
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3530
Mailing Address - Country:US
Mailing Address - Phone:732-282-1499
Mailing Address - Fax:732-415-3745
Practice Address - Street 1:1924 HWY 35
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3530
Practice Address - Country:US
Practice Address - Phone:732-282-1499
Practice Address - Fax:732-415-3745
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00658200111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHBFMedicare ID - Type Unspecified
GAU93156Medicare UPIN