Provider Demographics
NPI:1285732107
Name:JEFFREY H. MCGUNNIGLE, P.C.
Entity type:Organization
Organization Name:JEFFREY H. MCGUNNIGLE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:MCGUNNIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-310-4445
Mailing Address - Street 1:325 E ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1501
Mailing Address - Country:US
Mailing Address - Phone:856-310-4445
Mailing Address - Fax:856-310-4404
Practice Address - Street 1:510 S. WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106
Practice Address - Country:US
Practice Address - Phone:856-310-4445
Practice Address - Fax:856-310-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT28403Medicare UPIN
NJ089717VM9Medicare PIN
NJ103214Medicare PIN