Provider Demographics
NPI:1063419257
Name:PAPPACENA, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:PAPPACENA
Suffix:
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 1:140 US HIGHWAY 46
Mailing Address - Street 2:SUITE B
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-2516
Mailing Address - Country:US
Mailing Address - Phone:973-691-4333
Mailing Address - Fax:973-691-0993
Practice Address - Street 1:140 US HIGHWAY 46
Practice Address - Street 2:SUITE B
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-2516
Practice Address - Country:US
Practice Address - Phone:973-691-4333
Practice Address - Fax:973-691-0993
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC004687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ133126Medicare ID - Type UnspecifiedCHIROPRACTIC