Provider Demographics
NPI:1063602936
Name:ANNUNZIATA, CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:ANNUNZIATA
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 1:301 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1843
Mailing Address - Country:US
Mailing Address - Phone:856-275-1325
Mailing Address - Fax:866-306-7227
Practice Address - Street 1:300 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9388
Practice Address - Country:US
Practice Address - Phone:856-275-1325
Practice Address - Fax:866-306-7227
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00656000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor