Provider Demographics
NPI:1336147594
Name:OCCHIUZZI, CARMEN JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:JOHN
Last Name:OCCHIUZZI
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 1:909 BELMONT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2574
Mailing Address - Country:US
Mailing Address - Phone:973-423-3223
Mailing Address - Fax:973-423-2199
Practice Address - Street 1:909 BELMONT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2574
Practice Address - Country:US
Practice Address - Phone:973-423-3223
Practice Address - Fax:973-423-2199
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00155500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1871200Medicaid
NJ1871200Medicaid
NJ454839Medicare ID - Type Unspecified