Provider Demographics
NPI:1386774677
Name:RIPLEY, BARRETT WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:WILLIAM
Last Name:RIPLEY
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 1:90 BEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1017
Mailing Address - Country:US
Mailing Address - Phone:908-735-4500
Mailing Address - Fax:908-735-4554
Practice Address - Street 1:90 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1017
Practice Address - Country:US
Practice Address - Phone:908-735-4500
Practice Address - Fax:908-735-4554
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ451898Medicare UPIN