Provider Demographics
NPI:1386092989
Name:MARCHITELLI, JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MARCHITELLI
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 1:600 WARREN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2039
Mailing Address - Country:US
Mailing Address - Phone:732-359-7440
Mailing Address - Fax:732-359-7442
Practice Address - Street 1:600 WARREN AVE STE 104
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2039
Practice Address - Country:US
Practice Address - Phone:732-359-7440
Practice Address - Fax:732-359-7442
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00732600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor