Provider Demographics
NPI:1154405199
Name:MARZO, RICHARD H (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:MARZO
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 1:1070 STATE ROUTE 34
Mailing Address - Street 2:SUITE U
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3469
Mailing Address - Country:US
Mailing Address - Phone:732-888-8441
Mailing Address - Fax:732-888-8407
Practice Address - Street 1:1070 STATE ROUTE 34
Practice Address - Street 2:SUITE U
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3469
Practice Address - Country:US
Practice Address - Phone:732-888-8441
Practice Address - Fax:732-888-8407
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41817242OtherMULTIPLAN
NJ62688OtherCCN
NJ62688OtherFIRST HEALTH
NJ22747OtherAMERIGROUP
NJ5801563OtherGHI
NJ300052OtherASH
NJ050063918NJ01OtherANTHEM
NJ4586301Medicaid
NJX51421OtherEMPIRE BLUE
NJP1230774OtherOXFORD
NJ4586301Medicaid