Provider Demographics
NPI:1154424505
Name:DELANZO, RONALD ANTHONY JR (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ANTHONY
Last Name:DELANZO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-0478
Mailing Address - Country:US
Mailing Address - Phone:609-399-4717
Mailing Address - Fax:609-399-2561
Practice Address - Street 1:701 WEST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-3770
Practice Address - Country:US
Practice Address - Phone:609-399-4717
Practice Address - Fax:609-399-2561
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00636100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ124402Medicare PIN