Provider Demographics
NPI:1528109451
Name:SPERGEL, DREW EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:EVAN
Last Name:SPERGEL
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 1:315 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 3-C
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-533-0755
Mailing Address - Fax:973-533-0955
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:SUITE 3-C
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4896
Practice Address - Country:US
Practice Address - Phone:973-533-0755
Practice Address - Fax:973-533-0955
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00564400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU86624Medicare UPIN
NJ094808Medicare ID - Type Unspecified