Provider Demographics
NPI:1063594836
Name:NEGRI, MARY JEAN (RN, DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:JEAN
Last Name:NEGRI
Suffix:
Gender:F
Credentials:RN, DC
Other - Prefix:
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Mailing Address - Street 1:23 ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848
Mailing Address - Country:US
Mailing Address - Phone:973-579-1608
Mailing Address - Fax:973-579-7408
Practice Address - Street 1:23 ROUTE 15
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848
Practice Address - Country:US
Practice Address - Phone:973-579-1608
Practice Address - Fax:973-579-7408
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00238800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor