Provider Demographics
NPI:1861780892
Name:DELUCA FAMILY CHIROPRACTIC PA
Entity type:Organization
Organization Name:DELUCA FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-679-2414
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-0687
Mailing Address - Country:US
Mailing Address - Phone:732-679-2414
Mailing Address - Fax:732-679-1151
Practice Address - Street 1:2309 HIGHWAY 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1865
Practice Address - Country:US
Practice Address - Phone:732-679-2414
Practice Address - Fax:732-679-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty